Forceps jaw flanges

ABSTRACT

Forceps can include an outer tube, a first jaw, a second jaw, and an inner tube. The outer tube can extend along a longitudinal axis and can include a pair of outer arms extending from a distal portion of the outer tube. The first jaw can be pivotably connected to the outer tube and the first jaw can include a first flange and a second flange each located at a proximal portion of the first jaw. The first flange and the second flange can each include a proximal portion extending outward of the outer tube when the jaws are in an open position. The proximal portions can be shaped to limit extension of the proximal portions laterally beyond the outer arms.

PRIORITY CLAIM

This application claims priority to U.S. Ser. No. 62/826,532, filed onMar. 29, 2019, entitled “BLADE ASSEMBLY FOR FORCEPS”, the disclosure ofwhich is incorporated by reference in its entirety.

This application also claims priority to U.S. Ser. No. 62/826,522 filedon Mar. 29, 2019, entitled “SLIDER ASSEMBLY FOR FORCEPS”, the disclosureof which is incorporated by reference in its entirety.

This application also claims priority to U.S. Ser. No. 62/841,476, filedon May 1, 2019, entitled “FORCEPS WITH CAMMING JAWS”, the disclosure ofwhich is incorporated by reference in its entirety.

This application also claims priority to U.S. Ser. No. 62/994,220, filedon Mar. 24, 2020, entitled “FORCEPS DEVICES AND METHODS”, the disclosureof which is incorporated by reference in its entirety.

TECHNICAL FIELD

This document pertains generally, but not by way of limitation, tosystems and methods for actuating end effectors of medical devices. Inparticular, the systems and methods can be used with a forceps having anactuatable jaw and/or a blade.

BACKGROUND

Medical devices for diagnosis and treatment, including but not limitedto forceps, are used for medical procedures such as laparoscopic andopen surgeries. Forceps can be used to manipulate, engage, grasp, orotherwise affect an anatomical feature, such as a vessel or othertissue. Such medical devices can include an end effector that is one ormore of: rotatable, openable, closeable, extendable, retractable andcapable of supplying an input such as electromagnetic energy orultrasound.

For example, jaws located at a distal end of a forceps are typicallyactuated via elements at a handpiece of the forceps to cause the jaws toopen and close and thereby engage the vessel or other tissue. Forcepsmay also include an extendable and retractable blade, such as bladesthat can be extended distally between a pair of jaws.

There is a need for improved medical devices, including forceps. Aspectsdescribed herein provide a variety of improvements over conventionalforceps and other medical devices having a handpiece including anactuation system that controls an end effector.

BRIEF DESCRIPTION OF THE DRAWINGS

In the drawings, which are not necessarily drawn to scale, like numeralsmay describe similar components in different views. Like numerals havingdifferent letter suffixes may represent different instances of similarcomponents. The drawings illustrate generally, by way of example, butnot by way of limitation, various examples discussed in the presentdocument.

FIG. 1A illustrates a side view of a forceps showing jaws in an openposition.

FIG. 1B illustrates a side view of the forceps of FIG. 1A showing thejaws in a closed position.

FIG. 2 illustrates an exploded view of some components of the forceps ofFIG. 1A.

FIG. 3A illustrates a first partial cross-section view of a portion ofthe forceps of FIG. 1A.

FIG. 3B illustrates a second partial cross-section view of a portion ofthe forceps of FIG. 1A.

FIG. 3C illustrates a close-up exploded view of a portion of the forcepsof FIG. 1A.

FIG. 3D illustrates a third partial cross-section view of the forceps ofFIG. 3A showing a drive shaft motion transfer body in a rotatedposition.

FIG. 3E illustrates a fourth partial cross-section view of the forcepsof FIG. 3A showing the drive shaft motion transfer body in the rotatedposition of FIG. 3D.

FIG. 4A illustrates a partial cross-sectional view of the forceps ofFIG. 1A showing a lever in a distal position (e.g., unactuatedposition).

FIG. 4B illustrates a partial cross-sectional view of the forceps ofFIG. 1A showing the lever moved proximally (e.g., an actuated position).

FIG. 4C illustrates a partial cross-sectional view of the forceps ofFIG. 1A showing the lever moved further proximally (e.g., a forcelimiting state, an over-travel position).

FIG. 5A illustrates an exploded view of a portion of the forceps of FIG.1A including a drive shaft motion transfer assembly including a driveshaft motion transfer body, a clip, a drive shaft and a spring.

FIG. 5B illustrates an isometric view of the drive shaft motion transferbody of FIG. 5A in the assembled state.

FIG. 5C illustrates an isometric view of the drive shaft motion transferassembly of FIG. 5A in an assembled state (with the spring in acompressed, pre-loaded position).

FIG. 6A illustrates a partially exploded view of the drive shaft motiontransfer assembly of FIG. 5A showing the drive shaft motion transferbody assembled onto the drive shaft.

FIG. 6B illustrates an isometric view of the drive shaft motion transferassembly of FIG. 5A in a partially assembled state, with the springshown in cross-section.

FIG. 6C illustrates an isometric view of the drive shaft motion transferassembly of FIG. 5A, with the spring shown in cross-section.

FIG. 7A illustrates an isometric view of a second example of a driveshaft motion transfer assembly that can be used with the forceps of FIG.1A.

FIG. 7B illustrates an exploded view of the second example of the driveshaft motion transfer assembly of FIG. 7A.

FIG. 8A illustrates an isometric view of a third example of a driveshaft motion transfer assembly that can be used with the forceps of FIG.1A.

FIG. 8B illustrates an exploded view of the third example of the driveshaft motion transfer assembly of FIG. 8A.

FIG. 9A illustrates an isometric view of a fourth example of a driveshaft motion transfer assembly that can be used with the forceps of FIG.1A.

FIG. 9B illustrates an exploded view of the fourth example of the driveshaft motion transfer assembly of FIG. 9A.

FIG. 10A illustrates a side view of a portion of the forceps of FIG. 1Awith a rotational actuator in phantom.

FIG. 10B is cross-sectional view of the rotational actuator and an outerhub shown in FIG. 10A along line 10B-10B′ with the rotational actuatorshown in solid.

FIG. 11A illustrates a side view of a portion of the forceps of FIG. 1Awith the outer hub shown in phantom.

FIG. 11B is a cross-sectional view of the outer hub and the drive bodyof the shown in FIG. 11A along line 11B-11B′ with the outer hub shown insolid.

FIG. 12 illustrates a partial cross-sectional view of another example ofa drive shaft motion transfer body with an anchor portion including ananti-rotation key and an outer hub including a rotational keying slot.

FIG. 13A illustrates a side view of a portion of the forceps of FIG. 1Awith a lever in an unactuated position (e.g., retracted).

FIG. 13B illustrates a side view of the portion of the forceps of FIG.1A, with the lever in an actuated position.

FIG. 13C illustrates a side view of the portion of the forceps of FIG.1A, with the lever in a force limiting state (e.g., an over-travelposition).

FIG. 14A illustrates a side view of a drive link of the forceps of FIG.1A.

FIG. 14B illustrates a proximal isometric view of the drive link of theforceps of FIG. 1A.

FIG. 14C illustrates a distal isometric view of the drive link of theforceps of FIG. 1A.

FIG. 15A illustrates a side view of a portion of the forceps of FIG. 1Awith a first lever in an actuated position and a trigger in anunactuated position.

FIG. 15B illustrates a side view of the portion of the forceps of FIG.1A with the first lever in an actuated position and the second actuatorin an actuated position.

FIG. 16A illustrates cross-sectional view of a portion of the forceps ofFIG. 1A along line 16A-16A′ in FIG. 15A, and with the trigger in theunactuated position of FIG. 15A.

FIG. 16B illustrates a cross-sectional view of the portion of theforceps of FIG. 1A along line 16B-16B′ in FIG. 15B, and with the triggerin the actuated position of FIG. 15B.

FIG. 17A illustrates a side view of a subassembly of the forceps of FIG.1A held in a hand during assembly with some portions shown in phantom.

FIG. 17B illustrates a side view of the subassembly of FIG. 17A beinginserted into a first housing portion with some portions shown inphantom.

FIG. 17C illustrates a side view of the subassembly and housing of FIG.17B shown in solid.

FIG. 17D illustrates a proximal isometric view of the subassembly andhousing of FIG. 17C.

FIG. 18 illustrates a method of assembling a medical device, such as theforceps of FIG. 1A.

FIG. 19A illustrates a distal end of the forceps 1000 of FIG. 1Aincluding a wire harness routing.

FIG. 19B illustrates a portion of the forceps 1000 of FIG. 1A includingthe wire harness routing of FIG. 19A.

FIG. 20A illustrates an isometric view of a portion of a forceps in aclosed position.

FIG. 20B illustrates an isometric view of a portion of a forceps in apartially open position.

FIG. 20C illustrates an isometric view of a portion of a forceps in anopen position.

FIG. 21 illustrates a side view of a portion of a forceps in an openposition.

FIG. 22 illustrates a top view of a portion of a forceps in an openposition.

FIG. 23 illustrates an isometric view of a portion of a forceps.

FIG. 24 illustrates a side view of a portion of a forceps in an openposition

FIG. 25 illustrates a side isometric view of a portion of a forceps.

FIG. 26A illustrates a side view of a portion of a forceps with an innershaft and an outer shaft shown in phantom with a blade retracted.

FIG. 26B illustrates a side view of a portion of a forceps with an innershaft and an outer shaft shown in phantom with a blade extended.

FIG. 27 illustrates an isometric view of a portion of a forceps with aninner shaft and an outer shaft shown in phantom and with jaws removed.

FIG. 28 illustrates an isometric view of a portion of a forceps with aninner shaft and an outer shaft shown in phantom.

FIG. 29A illustrates an isometric view of a portion of a forceps with aninner shaft and an outer shaft shown in phantom.

FIG. 29B illustrates an isometric view of a portion of a forceps with aninner shaft and an outer shaft shown in phantom.

FIG. 29C illustrates an isometric view of a portion of a forceps with aninner shaft and an outer shaft shown in phantom.

FIG. 30A illustrates an isometric view of a portion of a forceps with aninner shaft in an extended position.

FIG. 30B illustrates an isometric view of a portion of a forceps with aninner shaft in a retracted position.

FIG. 30C illustrates an end view of a guide plug of a forceps.

FIG. 31A illustrates an end view of a guide plug of a forceps.

FIG. 31B illustrates an end view of a guide plug of a forceps.

FIG. 31C illustrates an end view of a guide plug of a forceps.

FIG. 32A illustrates a side view of a portion of a forceps.

FIG. 32B illustrates a perspective view of a portion of a forceps.

FIG. 33A illustrates a side view of a portion of a forceps

FIG. 33B illustrates a perspective view of a portion of a forceps.

FIG. 34A illustrates a side view of a portion of a forceps.

FIG. 34B illustrates a perspective view of a portion of a forceps.

FIG. 35A illustrates a side view of a portion of a forceps.

FIG. 35B illustrates a side view of a portion of a forceps.

FIG. 35C illustrates a side view of a portion of a forceps.

FIG. 36A illustrates a side view of a portion of a forceps.

FIG. 36B illustrates a side view of a portion of a forceps.

FIG. 36C illustrates a side view of a portion of a forceps.

FIG. 37A illustrates a side view of a forceps.

FIG. 37B illustrates a side view of a forceps.

FIG. 38 illustrates a side view of a portion of a forceps.

FIG. 39A illustrates a side view of a portion of a forceps.

FIG. 39B illustrates a side view of a portion of a forceps.

FIG. 39C illustrates a side view of a portion of a forceps.

FIG. 40A illustrates a side view of a jaw.

FIG. 40B illustrates a side view of a jaw.

FIG. 40C illustrates an end view of a jaw.

FIG. 40D illustrates an isometric view of a jaw.

FIG. 41A illustrates an isometric view of a jaw.

FIG. 41B illustrates a side view of a jaw.

FIG. 41C illustrates a side view of a jaw.

FIG. 41D illustrates an end view of a jaw.

FIG. 42 illustrates a side view of a portion of a forceps with an innershaft and an outer shaft shown in phantom.

FIG. 43 illustrates a side view of a portion of a forceps with an innershaft and an outer shaft shown in phantom.

FIG. 44 illustrates a side view of a portion of a forceps with an innershaft and an outer shaft shown in phantom.

FIG. 45 illustrates a cross-section view of a portion of a forcepsacross section C1-C1 of FIG. 42 .

FIG. 46 illustrates a cross-section view of a portion of a forcepsacross section C2-C2 of FIG. 42 .

FIG. 47 illustrates a side view of a portion of a forceps with an innershaft and an outer shaft shown in phantom.

FIG. 48 illustrates a cross-section view of a portion of a forcepsacross section 45-45 of FIG. 42 .

FIG. 49 illustrates a cross-section view of a portion of a forcepsacross section 46-46 of FIG. 42 .

FIG. 50 illustrates a side isometric view of a portion of a forceps.

FIG. 51A illustrates an end isometric view of a portion of a forceps.

FIG. 51B illustrates an end isometric view of a portion of a forceps.

FIG. 52A illustrates an end isometric view of a guide tube and bladeshaft.

FIG. 52B illustrates an end view of a guide tube.

FIG. 53 illustrates an exploded view of a jaw.

DETAILED DESCRIPTION

A medical device including a handpiece that operates an end effectorallows a surgeon to control the end effector of the device to actuateone or more functions of the end effector. Actuation of the end effectorcan be facilitated by one or more actuation systems of the handpiecethat can retract, extend or rotate one or more shafts to control theactions of the end effector.

The present inventors have recognized, among other things, thatconventional medical devices including a handpiece that actuates an endeffector can be improved to reduce packaging space, simplify design andmanufacturing, improve a user's experience, increase stability andprevent damage to the forceps.

This disclosure is generally related to medical devices, such assurgical instruments. Although the present application is described withreference to a forceps, other end effectors can be used with andoperated by the handpiece described herein. In addition, otherhandpieces can be connected to and can control the end effectorsdescribed herein. This disclosure includes examples of handpiecesincluding one or more actuation systems, examples of end effectors, andexamples where the disclosed actuation systems and end effectors can beused together in a medical device.

The forceps can include a medical forceps, a cutting forceps, anelectrosurgical forceps, or any other type of forceps. The forceps caninclude an end effector that is controlled by a handpiece including anactuation system to be one or more of: rotatable, openable, closeable,extendable, and capable of supplying electromagnetic energy orultrasound. For example, jaws located at a distal end of the forceps canbe actuated via one or more actuators at a handpiece of the forceps tocause the jaws to open, close and rotate to engage a vessel or othertissue. Forceps may also include an extendable and retractable blade,such as blades that can be extended distally in between a pair of jawsto separate a first tissue from a second tissue.

FIG. 1A illustrates a side view of a forceps 1000 with jaws 1012 in anopen position. FIG. 1B illustrates a side view of the forceps 1000 withthe jaws 1012 in a closed position. FIG. 2 illustrates an exploded viewof some components of the forceps 1000 of FIG. 1A. FIGS. 1A, 1B and 2are described together. Directional descriptors such as proximal anddistal are used within their ordinary meaning in the art. The proximaldirection P and distal direction D are indicated on the axes provided inFIG. 1A and FIG. 2 . FIG. 2 also shows the lateral directions L and L′,as well as top T and bottom B directions, which are defined when theforceps 1000 is held level with respect to a ground G in an uprightorientation as shown in FIG. 1A. Opposite to the lateral directions Land L′, is the medial direction, in other words, the medial direction istowards the centerline, or a longitudinal axis of the forceps 1000 (FIG.1B).

The illustrative forceps 1000 can include a handpiece 1001 at a proximalend, and an end effector 1002 at a distal end. An intermediate portion1006 can extend between the handpiece 1001 and the end effector 1002 tooperably couple the handpiece 1001 to the end effector 1002. Variousmovements of the end effector 1002 can be controlled by one or moreactuation systems of the handpiece 1001. In the illustrative example,the end effector 1002 can include the jaws 1012 that are capable ofopening and closing. The end effector 1002 can be rotated along alongitudinal axis A1 (FIG. 1B) of the forceps 1000. The end effector1002 can include a cutting blade 1032A (FIG. 2 ) and an electrode forapplying electromagnetic energy. All actuation system functions and allend effector actions are not required in all examples. The functionsdescribed herein can be provided in any combination.

An overview of features of the forceps 1000 is provided in FIGS. 1A, 1B,2, 3A-3E and 4A-4C. Further detailed illustration of example motiontransfer assemblies is provided in FIGS. 5A, 5B, 6A, 6B, 7A, 7B, 8A and8B. The illustrated motion transfer assemblies provide transmission offorces received from a user via clamping and rotational actuators (e.g.,a lever 1024 and a rotational actuator 1030), to the jaws 1012 of theforceps 1000 to actuate clamping and rotation of the jaws 1012.

As shown broadly in FIGS. 1A and 1B, with support from FIG. 2 , theforceps 1000 can include the jaws 1012, a housing 1014, a lever 1024, adrive shaft 1026, an outer shaft 1028, a rotational actuator 1030, ablade assembly (a blade shaft 1032 and a blade 1032A of FIG. 2 ), atrigger 1034 and an activation button 1036. In this example, the endeffector 1002, or a portion of the end effector 1002 can be one or moreof: opened, closed, rotated, extended, retracted, andelectromagnetically energized (e.g., electrically energized). In someexamples, the energy can be radio-frequency energy.

To operate the end effector 1002, the user can displace the lever 1024proximally by applying Force F1 (FIG. 1B) to drive the jaws 1012 fromthe open position (FIG. 1A) to the closed position (FIG. 1B). In theexample of forceps 1000, moving the jaws 1012 from the open position tothe closed position allows a user to clamp down on and compress atissue. The handpiece 1001 can also allow a user to rotate the endeffector 1002. For example, rotating rotational actuator 1030 causes theend effector 1002 to rotate by rotating both the drive shaft 1026 andthe outer shaft 1028 together.

In some examples, with the tissue compressed between the jaws 1012, auser can depress the activation button 1036 to cause an electromagneticenergy, or in some examples, ultrasound, to be delivered to the endeffector 1002, such as to an electrode. Application of electromagneticenergy can be used to seal or otherwise affect the tissue being clamped.In some examples, the electromagnetic energy can cause tissue to becoagulated, cauterized, sealed, ablated, desiccated or can causecontrolled necrosis. Example electrodes are described herein, butelectromagnetic energy can be applied to any suitable electrode.

The handpiece 1001 can enable a user to extend and retract a blade 1032Aattached to a distal end of a blade shaft 1032 (FIG. 2 ). The blade1032A can be extended by displacing the trigger 1034 proximally. Theblade 1032A can be retracted by allowing the trigger 1034 to returndistally to a default position. The default position of the trigger 1034is shown in FIG. 1A. In some examples, as described herein, thehandpiece 1001 can include features that inhibit the blade 1032A frombeing extended until the jaws 1012 are at least partially closed, orfully closed.

The forceps 1000 can be used to perform a treatment on a patient, suchas a surgical procedure. In an example, a distal portion of the forceps1000, including the jaws 1012, can be inserted into a body of a patient,such as through an incision or another anatomical feature of thepatient's body. While a proximal portion of the forceps 1000, includinghousing 1014 remains outside the incision or another anatomical featureof the body. Actuation of the lever 1024 causes the jaws 1012 to clamponto a tissue. The rotational actuator 1030 can be rotated via a userinput to rotate the jaws 1012 for maneuvering the jaws 1012 at any timeduring the procedure. Activation button 1036 can be actuated to provideelectrical energy to jaws 1012 to coagulate, cauterize or seal thetissue within the closed jaws 1012. Trigger 1034 can be moved totranslate the blade 1032A distally to cut the tissue within the jaws1012.

In some examples, the forceps 1000, or other medical device, may notinclude all the features described or may include additional featuresand functions, and the operations may be performed in any order. Thehandpiece 1001 can be used with a variety of other end effectors toperform other methods.

As shown in the combination of FIG. 1A, FIG. 1B and FIG. 2 , the forceps1000 can include various components. For example, a first housingportion 1016 and a second housing portion 1018. As shown in FIG. 2 , thefirst housing portion 1016 and the second housing portion 1018 can mateat a coupling joint 1017. The housing 1014 can include, or be coupledto, a handle portion 1020A and 1020B, such as a fixed handle that isconfigured to be held in the hand of a user during use.

The housing 1014 can be a frame that provides structural support betweencomponents of the forceps 1000. The housing 1014 is shown as housing atleast a portion of the actuation systems associated with the handpiece1001 for actuating the end effector 1002. However, some or all of theactuation components need not necessarily be housed within the housing1014. Components described herein may be completely housed within thehousing 1014 through all or a portion of the range of motion of thecomponents of the actuation system; partially housed through all or aportion of the range of motion of the components of the actuationsystem; or completely external to the housing 1014 during all or aportion of the range of motion of the components of the actuation systemassociated with the handpiece 1001. In some examples, the housing 1014provides a rigid structure for attachment of components, but the housing1014 does not necessarily house the components completely, or onlyhouses a portion of some of the components.

With continued reference to FIG. 1A, FIG. 1B and FIG. 2 , the driveshaft 1026 can extend through the housing 1014 and out of a distal endof the housing 1014, or distally beyond housing 1014. The jaws 1012 canbe connected to a distal end of the drive shaft 1026. The outer shaft1028 can be a hollow tube positioned around the drive shaft 1026. Adistal end of the outer shaft 1028 can be located adjacent the jaws 1012and the jaws 1012 can be connected to the outer shaft 1028. The distalends of the drive shaft 1026 and the outer shaft 1028 can berotationally locked (e.g., rotationally constrained) to the jaws 1012.The rotational actuator 1030 can be positioned around the distal end ofthe housing 1014. In the illustrative example, the rotational actuator1030 is indirectly connected to a proximal end of the outer shaft 1028by an outer hub 1060, however, in some examples the rotational actuator1030 can be directly connected to the proximal end of the outer shaft1028 or can integrally include the features of the outer hub 1060. Insome examples, various rotational constraints described herein can beemployed independently. In other words, some examples can employ asingle rotational constraint between the rotational actuator 1030 andthe jaws 1012, while in other examples, the rotational constraint caninclude multiple rotational constraints at different locations along thelongitudinal axis A1, such as a first rotational constraint proximate orwithin the handpiece 1001, and a second rotational constraint proximatethe end effector 1002 and distal of the handpiece 1001, as describedfurther in various examples herein.

The outer shaft 1028 can extend distally beyond the rotational actuator1030. The blade shaft 1032 can extend through the drive shaft 1026 andthe outer shaft 1028. A distal end of the blade shaft 1032 including theblade 1032A can be located adjacent to the jaws 1012. A proximal end ofthe blade shaft 1032 can be within the housing 1014.

A proximal portion 1034A (FIG. 2 ) of the trigger 1034 can be connectedto the blade shaft 1032 within the housing 1014. A distal portion 1034B(FIG. 2 ) of the trigger 1034 can extend outside of the housing 1014adjacent, and in some examples, nested with the lever 1024 in thedefault or unactuated positions shown in FIG. 1A. Activation button 1036can be coupled to the housing 1014. Activation button 1036 can actuateelectronic circuitry within housing 1014 that can send electromagneticenergy through forceps 1000 to the jaws 1012. When the user presses onthe activation button 1036, the activation button 1036 can move relativeto the housing 1014. For example, when the activation button 1036 ispressed, an electrical switch on a flexible printed circuit board thatis secured to the housing 1014 can be closed. Wiring and electricalcomponents such as a dome switch that can be actuated by the activationbutton 1036, are further shown in FIG. 19 . In some examples, theactivation button 1036 or the electronic circuitry may reside outsidethe housing 1014 but may be operably coupled to the housing 1014 and theend effector 1002. In some examples, activation of the forceps 1000 canbe accomplished by a foot or knee actuated switch.

As shown in the exploded view of a portion of the forceps 1000 in FIG. 2, the forceps 1000 can include the handpiece 1001 having components foran actuation system, the end effector 1002, the intermediate portion1006, the jaws 1012, the housing 1014 (including the first housingportion 1016, the second housing portion 1018, the handle portion 1020Aand 1020B, the stabilizing flange 1021, and a recess or opening 1021A),the handle locking mechanism 1022, the lever 1024, the drive shaft 1026(including the first horizontal slot 1069A and the second horizontalslot 1069B, the outer shaft 1028, the rotational actuator 1030, theblade shaft 1032, the blade 1032A the trigger 1034, and the activationbutton 1036, a first pin 1038, a lever return spring 1040, a couplinglink 1042, a second pin 1044, a drive link 1046, a third pin 1048, afourth pin 1050, a drive shaft motion transfer body 1052 (hereinafter,drive body 1052 or slider block), a force-limiting spring 1054, a clip1056, an O-ring 1058, an outer hub 1060, a nose 1062, a spool 1064(e.g., cut block or second drive shaft motion transfer body), a crosspin 1066 (e.g., a blade pin), and a trigger return spring 1068. Thehandle locking mechanism 1022 can be, for example, of the type describedin U.S. patent application Ser. No. 15/941,205 to Boone, titled “ForcepsIncluding a Pre-loaded Handle Latch” filed on Mar. 30, 2018, thedisclosure of which is incorporated by reference in its entirety.Furthermore, the components which make up the actuation system can be,for example, of the type described in U.S. patent application Ser. No.15/839,218 to Butler titled “Laparoscopic Forceps Assembly with AnOperable Mechanism” filed on Dec. 12, 2017. the disclosure of which isincorporated by reference in its entirety.

As a general overview of the component interaction of the handpiece 1001of the forceps 1000, the forceps 1000 can include the drive body 1052being constrained to the drive shaft 1026 to transfer motion to thedrive shaft 1026, thereby operating the jaws 1012. However, in a forcelimiting state (e.g., position), the drive body 1052 can be slidablewith respect to the drive shaft 1026. Thus, the forceps 1000 can beconfigured to limit a force on the jaws 1012 to protect the jaws 1012from damage when the lever 1024 is being closed with the jaws 1012 stuckin an open or partially open position. An example of the jaws 1012 stuckin such a position is shown in FIG. 13C.

As further shown and described here and elsewhere in the disclosure, thedrive body 1052 along with the clip 1056 can lock the drive shaft 1026to the rotational actuator 1030 such that the drive shaft 1026 and theouter shaft 1028 are rotationally locked (e.g., rotationallyconstrained) together at a proximal portion of the drive shaft 1026 andthe outer shaft 1028 proximate the rotational actuator 1030. Further,the forceps 1000 can include the trigger 1034, the spool 1064 proximalto the drive body 1052 and connected to the trigger 1034, and a triggerreturn spring 1068 positioned between the drive body 1052 and the spool1064 to bias the blade shaft 1032 with blade 1032A proximally but allowmovement of the blade 1032A distally to perform a cut, while improvingthe design of the forceps.

FIGS. 3A, 3B, 3C, 3D and 3E focus on the clamping and rotational aspectsof the forceps and will be described together with support from FIGS.1A, 1B and 2 . Many of these components are introduced here, but alsoshown and described in further detail in other figures herein. Somecomponents related to the cutting functions of the forceps of FIG. 1Aare absent in FIGS. 3A, 3B and 3C to provide better visibility of othercomponents. While FIGS. 3A, 3B, 3C, 3D and 3E illustrate components thatmake up the actuation system of the handpiece 1001, the function andinterrelationship of the components are described throughout thisdisclosure.

FIG. 3A illustrates a first partial cross-section view of a portion ofthe forceps 1000 of FIG. 1A, FIG. 1B and FIG. 2 , in accordance with atleast one example. The lever 1024, the drive shaft 1026, the drive body1052, the force-limiting spring 1054, the clip 1056, the O-ring 1058 andthe outer shaft 1028 are not shown in cross section. FIG. 3B illustratesa second partial cross-section view of a portion of the forceps 1000, inaccordance with at least one example. The drive shaft 1026 and the outershaft 1028 are not shown in cross-section. FIG. 3C illustrates aclose-up exploded view of a portion of the forceps 1000 of FIG. 1A, inaccordance with at least one example. FIG. 3D illustrates a thirdpartial cross-section view of the forceps 1000 of FIG. 3A showing thedrive body 1052 in a rotated position, in accordance with at least oneexample. The drive body 1052, the force-limiting spring 1054, the O-ring1058, and the outer shaft 1028 are not shown in cross-section. FIG. 3Eillustrates a fourth partial cross-section view of the forceps 1000 ofFIG. 3A showing the drive body 1052 in the rotated position of FIG. 3D,in accordance with at least one example. The outer shaft 1028 is notshown in cross section.

FIGS. 3A, 3B, 3C, 3D and 3E, described together with most componentsshown in the exploded view of FIG. 3C, include the housing 1014(including the first housing portion 1016, the handle portion 1020A, andstabilizing flange 1021), the lever 1024, the first pin 1038, the driveshaft 1026, the lever return spring 1040, the coupling link 1042 canreside within a lever recess 1025, the second pin 1044, the drive link1046, the third pin 1048, the fourth pin 1050, a drive motion transferassembly 1051, the drive body 1052, the force-limiting spring 1054, theclip 1056, the O-ring 1058, the outer shaft 1028, the outer hub 1060, asleeve 1061, the rotational actuator 1030, and the nose 1062. The driveshaft 1026 includes the first horizontal slot 1069A, the secondhorizontal slot 1069B, a first vertical slot 1070A, and a secondvertical slot 1070B, which can be an opening extending through the driveshaft 1026, or a recess or deformation in the drive shaft 1026. Thedrive body 1052 (shown in further detail in other drawings herein aswell) can include a body portion 1072, an anchor portion 1074 (includinga distal spring seat 1076 and a rotational keying slot 1078), acylindrical portion 1080, a window portion 1082 (including a firstwindow 1084A and a second window 1084B, see FIG. 3C), a neck portion1086, a collar 1088 (such as proximal collar 1088 including a drivesurface 1090A and a second distal spring seat 1091, see FIGS. 3B and 3C,as well as FIG. 5A for a close-up view), and a passageway 1092 (e.g. achannel, a bore, a recess, or an aperture extending therethrough). Thesleeve 1061 can include a flange 1094. In some examples, such as anexample where the sleeve 1061 is omitted, the outer shaft 1028 caninclude the flange 1094. The outer hub 1060 can include groove 1096,interior surface 1098, and the anti-rotation key 1100 (FIGS. 3D and 3E).

The first and second horizontal slots 1069A, 1069B can extendlongitudinally along the drive shaft 1026, in an axial direction,parallel to longitudinal axis A1 (FIG. 1B). In other words, the firstand second horizontal slots 1069A, 1069B can be described as extendinghorizontally when the drive shaft 1026 is held level. In some examples,the first and second vertical slots 1070A may extend along or within aplane perpendicular to the longitudinal axis A1.

The drive shaft 1026 can include the first vertical slot 1070A on afirst side and the second vertical slot 1070B on a second side (FIG. 3B,3C, further shown and described in FIGS. 5A-5C and 6A-6C). The verticalslots 1070A and 1070B can be perpendicular to the longitudinal axis A1(FIG. 1B) of drive shaft 1026. The first vertical slot 1070A and secondvertical slot 1070B can extend into the drive shaft 1026 from anexterior surface of the drive shaft 1026. The first vertical slot 1070Aand the second vertical slot 1070B can be sized to accept the clip 1056.In some examples, the clip 1056 can be ridged and can be accepted ontothe drive shaft 1026 without distorting the shape of the clip 1056. Insome examples, the drive shaft 1026 can have a single vertical slot1070A or 1070B. The first and second vertical slots 1070A, 1070B can beprovided as an opening/aperture or as a deformation with or without anopening through the drive shaft 1026.

As shown in the combination of FIGS. 3A-3E, and in close-up views ofFIGS. 5A-5C and 6A-6C, the drive body 1052 can include the body portion1072 and the anchor portion 1074 connected, or integrally formed, atdistal end of the body portion 1072. The anchor portion 1074 can extendoutwardly from an outer surface of body portion 1072. As such, theanchor portion 1074 can include the distal spring seat 1076 at aproximal end surface of the anchor portion 1074. The distal spring seat1076 can be connected to a distal end of the body portion 1072.

As shown in FIGS. 3C, 3D and 3E, and as shown in further detail in otherfigures herein, including some features shown close-up in FIG. 5A, theanchor portion 1074 can include the rotational keying slot 1078. Therotational keying slot 1078 is also shown close-up in FIG. 5A. Therotational keying slot 1078 can be horizontal slot, or a slot extendingparallel to the longitudinal axis A1 of the drive shaft 1026 (A1 isshown in FIG. 1B). The rotational keying slot 1078 can extend into aside of the body portion 1072. In alternate examples, the drive body1052 may have any number of the rotational keying slot(s) 1078. In someexamples, the rotational keying slot 1078 can be any other suitablekeying interface known in the art and are not necessarily provided as aslot. The interaction between the rotational keying slot 1078 and ananti-rotation key 1100 of the outer hub 1060 is further describedherein. The rotational keying slot 1078 and the anti-rotation key 1100on the outer hub 1060 can be any type of interface that limits relativerotation between the drive body 1052 and the outer hub 1060. Forexample, the rotational keying slot 1078 can be a protrusion instead ofa slot to be received by the anti-rotation key 1100 that is a slot,recess or groove of the outer hub 1060 in order to provide the relativeanti-rotation features between the drive body 1052 and the outer hub1060.

The cylindrical portion 1080 of the drive body 1052 can be connected to,or integrally formed with, the distal end of the anchor portion 1074.The cylindrical portion 1080 can be sized to accept the O-ring 1058.

As shown in the exploded view of FIG. 3C, and in additional detail inother figures herein, the window portion 1082 can include the firstwindow 1084A extending through the first side of body portion 1072 andthe second window 1084B opposite the first window 1084A and extendingthrough the second side of body portion 1072. Although described as awindow, in some examples the window portion 1082 may be provided as atrack, such a window or track need not necessarily be bounded on allsides, and sections of the window or track may not extend entirelythrough the body portion 1072.

As shown in FIGS. 3A, 3B and 3C, with some features shown close-up inFIG. 5A, the neck portion 1086 of the drive body 1052 can be connectedto a proximal end of the body portion 1072. The neck portion 1086 canhave an outer diameter smaller than the outer diameter of the bodyportion 1072 (e.g., a minor diameter surface). The collar 1088 can beconnected to a proximal end of the neck portion 1086. The collar 1088can have an outer diameter greater than the outer diameter of the neckportion 1086 and less than an inner diameter of the force-limitingspring 1054.

The collar 1088 can include the drive surface 1090A at a distal endsurface of the collar 1088 and the second distal spring seat 1091 at aproximal end of the collar 1088, or a proximal end of the drive body1052. As such, the drive surface 1090A can be fixedly connected to orintegrally molded to the proximal end of the neck portion 1086. Althoughthe neck portion 1086 and associated flanges, such as drive surface1090A and the second distal spring seat 1091 are shown and described asbeing located or connected to a proximal end of the body portion 1072,they could be located elsewhere on the drive body 1052, such as along acentral portion or distal portion of the drive body 1052, such as distalof the distal spring seat 1076.

The passageway 1092 in the drive shaft 1026 (FIG. 3B, 3C) can be shapedto accept the drive shaft 1026. The passageway 1092 can be a cylindricalor non-cylindrical aperture extending through the cylindrical portion1080, the anchor portion 1074, the body portion 1072, the window portion1082, the neck portion 1086, and the collar 1088.

The drive shaft 1026 can extend through the passageway 1092 (FIG. 3B) ofthe drive body 1052 such that the drive body 1052 can be positionedaround at least a portion of the drive shaft 1026. The force-limitingspring 1054 can be positioned on the body portion 1072 and over thewindow portion 1082 of the drive body 1052. A distal end of theforce-limiting spring 1054 can contact the distal spring seat 1076. Theclip 1056 can be positioned on the window portion 1082 of the drive body1052 and can connect to drive shaft 1026 at the first vertical slot1070A and the second vertical slot 1070B. Examples of clips and windowsare described further herein, and for example, in FIGS. 4A, 4B, 4C, 5A,5B, 5C, 6A, 6B, 6C, 7A, 7B, 8A, 8B, 9A and 9B.

As shown in FIGS. 3A and 3B, and with support for some features shownclose-up in FIGS. 5A, 5B, 5C, 6A, 6B, 6C, a proximal end of theforce-limiting spring 1054 can contact a distal end surface of the clip1056. As such, the force-limiting spring 1054 can be positioned on thedrive body 1052 between the distal spring seat 1076 of anchor portion1074 and the clip 1056. In this arrangement, the clip 1056 is fixed tothe drive shaft 1026 but can be longitudinally movable with respect tothe drive body 1052 within and along window portion 1082 (FIGS. 4A, 4B,4C) when a preload on the force-limiting spring 1054 is exceeded by theforce applied to the lever 1024. As shown close-up in FIG. 5A, a clipsupport surface 1081 of the body portion 1072 can be adjacent a proximalend of the window portion 1082, and a distal support surface 1083 of thebody portion 1072 can be adjacent a distal end of the window portion1082. In some examples, the clip support surface 1081 and the distalsupport surface 1083 can function as longitudinal stops for the clip1056 and impose the preload on the force-limiting spring 1054. In anexample, the preload can be in a range between 50-150 Newtons. In apossibly more preferred examples, to improve user experience, thepreload can be in a range between 70-90 Newtons, or 135-155 Newtons,depending on the design. Unlike conventional clips, the clip 1056 can beconfigured to support such high preloads in combination with features ofthe clip 1056 that couple the clip 1056 to the drive body 1052 and thedrive shaft 1026. One of the benefits of such ranges in combination withthe forceps 1000 design, including the clip design 1056, is that suchpreloads can provide adequate jaw 1012 sealing pressure on a tissue,without requiring an excessive input Force F to actuate lever 1024.Furthermore, a single actuating jaw can deliver roughly twice thesealing pressure at the jaws 1012 than a dual-actuating jaw, given thesame preload on the force-limiting spring 1054.

To cause driving of the jaws 1012 between the open and closed positionsshown in FIGS. 1A and 1B, the lever 1024 is moved proximally or distallywhich moves the drive body 1052 proximally or distally. The drive link1046 can be operably coupled to the housing 1014 and the drive body 1052such that the drive link 1046 is configured to transfer a force receivedat the lever 1024 into a linear motion of the drive body 1052 and thedrive shaft 1026 relative to the housing 1014. For example, the drivelink 1046 can be connected to the drive body 1052 at the neck portion1086. The legs 1046B of drive link 1046, shown in FIG. 3C, can fitaround the neck portion 1086. When the lever 1024 is moved proximally,the drive link 1046 can contact and push against the drive surface 1090Aof the collar 1088. The location of the drive surface 1090A is showngenerally in the cross-sectional view of FIGS. 3B and 3C and close-up inFIG. 5A. In contrast, when the lever 1024 is moved distally, the drivelink 1046 can move distally, contacting and pushing against a proximalend surface 1090B of body portion 1072 of drive body 1052, also shown inclose-up of FIG. 5A.

During a surgical procedure, carbon dioxide or other gas may be used forinsufflation, which introduces a pressure differential between the bodycavity and the external environment. As shown in FIGS. 3A-3E, to preventleakage, the O-ring 1058 can create a seal between the drive shaft 1026and the outer hub 1060 so that the pressure differential between thebody cavity in which the distal portion of forceps 1000 is positionedand the external environment in which the proximal portion of forceps1000 is located, is maintained (e.g., pneumatically sealed,substantially pneumatically sealed). In some examples, the O-ring 1058can be positioned adjacent and distal to the cylindrical portion 1080.Likewise, sealing features within the drive shaft 1026, which can be ahollow tube, can provide similar sealing capabilities to prevent theleakage of air from the body cavity to the external environment in whichthe proximal portion of forceps 1000, is located. Such sealing featurescan include a guide plug 2530, such as is shown in FIG. 31A.

The sleeve 1061 or the outer shaft 1028 can include the flange 1094 at aproximal end of the sleeve 1061 or the outer shaft 1028. In the exampleshown, the sleeve 1061 includes the flange 1094. In some examples, theflange 1094 can be welded to, or formed in, the sleeve 1061 or the outershaft 1028. The flange 1094 can fit within the groove 1096 of outer hub1060. The flange 1094 can improve the ability to affix the sleeve 1061or outer shaft 1028 to the outer hub 1060. For example, the flange 1094can fit in the groove 1096 in the outer hub 1060. The groove 1096 canform a ring in the interior surface 1098 of the outer hub 1060. In someexamples, the outer hub 1060 can be molded to the outer shaft 1028. Inanother example, the outer hub 1060 can be overmolded on to the sleeve1061. In such a case, there is not necessarily a groove 1096, but theshape of the outer hub 1060 that accepts the flange 1094 can be formedby the overmolding of the outer hub 1060 onto the flange 1094.

To rotationally fix the outer hub 1060 to the drive body 1052, as shownin FIGS. 3D and 3E, the anti-rotation key 1100 can include a ridge thatextends out of the interior surface 1098 of the outer hub 1060 into achannel of the outer hub 1060. For example, the anti-rotation key 1100can be sized to fit within the rotational keying slot 1078 of the anchorportion 1074. The rotational keying slot 1078 can accepts theanti-rotation key 1100, which can be positioned within the rotationalkeying slot 1078 such that the rotational keying slot 1078 can belinearly translated, or longitudinally moved, along the anti-rotationkey 1100. These features are shown in further detail in FIGS. 11A and11B.

The flange 1094 and the groove 1096 or other formation can connect andlock the outer shaft 1028 to the outer hub 1060. The anti-rotation key1100 and rotational keying slot 1078 can connect and rotationally lockthe outer hub 1060 and the drive body 1052. Also, the drive shaft 1026can be rotationally locked to the drive body 1052 by the clip 1056.Thus, rotating rotational actuator 1030 rotates the outer hub 1060,which rotates both the outer shaft 1028 and the drive shaft 1026. Theconnection between the outer hub 1060, the drive body 1052 and therotational actuator 1030 is shown and described in further detail withreference to FIGS. 10A, 10B, 11A and 11B. Alternate examples ofconnections between the outer hub 1060, the drive body 1052 and arotational actuator 1030 are described with reference to FIG. 12 .

As shown in FIG. 3C, to improve stabilization of the drive shaft 1026while allowing one or both of rotation and longitudinal motion, thefirst housing portion 1016 can include the stabilizing flange 1021including a recess or the opening 1021A through which a proximal end ofthe drive shaft 1026 can extend into or through.

To provide articulation of the lever 1024, the lever 1024 can beoperably coupled to the housing 1014 via the first pin 1038. The lever1024 can be movable about the first pin 1038 by a pivoting motion. Inthe example, the first pin 1038 is retained in the housing 1014. Inother examples, the first pin 1038 may be retained by the lever 1024 ormay be part of the lever 1024. As shown in FIG. 3A, the lever 1024 canbe biased to a default position (FIG. 1A) by lever return spring 1040.In the example, lever return spring 1040 can be constrained between thehousing 1014 and the lever 1024. In some examples, the lever returnspring 1040 can be provided as any suitable type of biasing element,such as a helical spring, an elastomeric component, an elastomeric band,or an elastomeric block arranged to bias the lever to a defaultposition. Such a biasing element can be strained, for example bycompression, extension, torsion or deflection, and elastically return toits original form, or substantially original form.

As a general overview, to transmit an input motion (e.g., input forceF1) received at the lever 1024, a first end of the coupling link 1042can be connected to the lever 1024 via the second pin 1044. A second endof the coupling link 1042 can be connected to a first end of the drivelink 1046 via the third pin 1048. As such, the coupling link 1042 canconnect the lever 1024 to the drive link 1046. A second end of the drivelink 1046 can be connected to the housing 1014 via the fourth pin 1050.The drive link 1046 can be formed as a yoke. For example, as shown inFIG. 3C, the drive link 1046 can include a base 1046A between the firstend and the second end of the drive link 1046. A pair of spaced apartlegs 1046B can extend from the base 1046A of drive link 1046 such thatthe ends of the legs 1046B form the second end of drive link 1046 (alsosee FIG. 14B).

The illustrative forceps 1000 includes a drive shaft motion transferassembly 1051 coupled to the housing 1014. The drive shaft motiontransfer assembly 1051 can include the drive body 1052 which functionsto transmit an input force F1 from the lever 1024 to the drive shaft1026 to retract or extend the drive shaft 1026 (e.g., to open or closejaws 1012).

In addition to transmitting the input force F1 from the lever 1024 tothe drive shaft 1026, in some examples, and as shown in the exampleforceps 1000, the drive shaft motion transfer assembly 1051, includingthe drive body 1052 can also transmit a rotational motion from therotational actuator 1030, through the outer hub 1060, to both the driveshaft 1026 and the outer shaft 1028. However, not all examples of thedrive body 1052 require that the drive body 1052 transmit both alongitudinal motion and a rotational motion to the drive shaft 1026. Insome examples, the drive body 1052 may only be configured to transmitone or the other of a longitudinal motion and a rotational motionthrough the drive body 1052 to the drive shaft 1026. For example, somemedical devices may employ the extension or retraction features offorceps 1000 but without rotation; and vice versa, other medical devicesmay employ the rotation features without the extension or retractionfeatures.

In the illustrative drive shaft motion transfer assembly 1051, the drivebody 1052 can be positioned around the drive shaft 1026. The drive shaft1026 can extend through a passageway 1092 in the drive body 1052 (FIG.3B, FIG. 3C). In some examples, the passageway 1092 may be formed as acenter bore, though in some examples, the passageway 1092 does not needto be central and/or does not need to be provided as a circular bore. Inother examples, the passageway 1092 can be square, polygonal, irregular,or include a notch. In some examples, the passageway 1092 can include achannel. In some examples the passageway 1092 may not surround the driveshaft 1026.

The drive body 1052 can be located distal with respect to the lever 1024and can be coupled to the lever 1024. In the example, the drive body1052 is coupled to the lever 1024 indirectly through a series oflinkages. The drive body 1052 can be connected to and receive an inputforce F1 from the lever 1024 via the drive link 1046 to retract orextend the drive shaft 1026 relative to the housing 1014 and the outershaft 1028 (thereby closing or opening the jaws 1012). The drive body1052 can be positioned within the yoke formed by the drive link 1046 toreceive the input from the drive link 1046.

The drive shaft motion transfer assembly 1051 can include theforce-limiting spring 1054 and the clip 1056. The force-limiting spring1054 can be positioned around the drive body 1052. The clip 1056 can bepositioned on the drive body 1052 adjacent and end of the force-limitingspring 1054. The clip 1056 can be fixed to the drive shaft 1026. In someexamples, the force-limiting spring 1054 can be any suitable type ofbiasing element such as an elastomeric component, an elastomeric band,or an elastomeric block that can be elastically deformed and return toits original state, or substantially original state. In some examples,clip 1056 may be inserted onto the drive shaft 1026 via one or moreslots (such as vertical slots 1070A and 1070B). In some examples theclip can be flat, while in other examples, the clip may be non-planar orhave irregular, non-flat surfaces.

In some examples, the drive shaft motion transfer assembly 1051 caninclude the outer hub 1060 which can be connected to the drive body1052. The outer hub 1060 can include an interior surface 1098 withinwhich the drive body 1052, the force-limiting spring 1054, and the clip1056 (FIG. 3A, FIG. 3C) can translate longitudinally together.

The rotational actuator 1030 can be positioned around and connected tothe outer hub 1060. The rotational actuator 1030 can be rotationallyconstrained to the outer hub 1060 and axially constrained to the outerhub 1060. The rotational actuator 1030 can also be axially constrainedwith respect to the housing 1014. The nose 1062 can be connected to adistal end of the outer hub 1060, for example, by a snap fit, adhesiveor threaded connection. The drive shaft 1026 and the outer shaft 1028can extend through and out of nose 1062. In some examples the rotationalactuator 1030 and/or the nose 1062 can be omitted and the outer hub 1060can act as the rotational actuator 1030 and/or the nose 1062 to receivea rotation input directly from a user. In some examples, instead of thenose 1062 being connected to a distal end of the outer hub 1060, thenose 1062 can be connected directly to the rotational actuator 1030, forexample, by a snap fit, adhesive or threaded connection.

In the example of FIG. 3A, axial retention of the rotational actuator1030 relative to housing 1014 can be provided by axially constrainingthe rotational actuator 1030 between the housing 1014 and the nose 1062.A connection between a first snap fit connector 1060C on the outer hub1060 and a second snap fit connector 1062C on the nose 1062 canconstrain the rotational actuator 1030 from moving distally. The firstand second snap fit connectors are shown merely as an example, any typeof snap fit connectors, or otherwise, may be provided. In thisarrangement, the outer hub 1060 can be axially constrained with respectto the housing 1014 by a proximal housing flange 1060A and a distalflange 1060B of the outer hub 1060, which can be captured by surfaces ofthe housing 1014 that interface with the proximal housing flange 1060Aand the distal flange 1060B. Furthermore, since the nose 1062 is axiallyconstrained to the outer hub 1060, the rotational actuator 1030 can alsobe axially constrained to the outer hub 1060, the nose 1062 and thehousing 1014 by being captured between the nose 1062 and the housing1014. In other words, the nose 1062 engages the outer hub 1060 in anaxial direction to provide axial retention of both the nose 1062 as wellas the rotational actuator 1030.

FIG. 4A illustrates a partial cross-sectional view of the forceps 1000of FIG. 1A showing the lever 1024 in a distal position (e.g., anunactuated position), in accordance with at least one example. FIG. 4Billustrates a partial cross-sectional view of the forceps 1000 of FIG.1A showing the lever 1024 being moved proximally (e.g., an actuatedposition, one of a plurality of actuated positions or user positions),in accordance with at least one example. FIG. 4C illustrates a partialcross-sectional view of the forceps 1000 of FIG. 1A showing the lever1024 moved further proximally (e.g., into a further actuated position,which in some examples can be a fully-actuated position, and in thiscase, into a force limiting or over-travel state), in accordance with atleast one example. Note that a force limiting state is a position of thedrive body 1052 that occurs when a force applied to the lever 1024 andtransferred to the drive body 1052 exceeds a predetermined force that isbased on a preload of the force-limiting spring 1054. Force limiting canoccur in other actuated positions whenever the predetermined force isexceeded.

FIG. 4A, FIG. 4B, and FIG. 4C will be discussed together and provide ageneral illustration of how the drive body 1052, the force-limitingspring 1054, and the clip 1056 can function on the drive shaft 1026 inresponse to the lever 1024 providing an input to a linkage between thelever 1024 and the drive body 1052. The components of the forceps 1000shown in FIG. 4A, FIG. 4B, and FIG. 4C include the housing 1014 havingstabilizing flange 1021, the lever 1024, the drive shaft 1026, thetrigger 1034, the coupling link 1042, the drive link 1046, the drivebody 1052, the force-limiting spring 1054, the clip 1056, the outer hub1060, a spool 1064, the cross pin 1066, and the trigger return spring1068. The drive shaft 1026 can include the first horizontal slot 1069A,the second horizontal slot 1069B, the first vertical slot 1070A, and thesecond vertical slot 1070B (hidden here, but viewable in FIG. 3C). Thedrive body 1052 includes the body portion 1072, the anchor portion 1074(including distal spring seat 1076), the window portion 1082 (includingthe first window 1084A and the second window 1084B, the neck portion1086, and the collar 1088 (including the drive surface 1090A and thesecond distal spring seat 1091, also shown in FIG. 3C, and close-up inFIG. 5A). The outer hub 1060 includes the interior surface 1098. Thespool 1064 can include a proximal trigger return spring seat 1101. Thespool 1064 is shown as one example of a motion transfer body designed totransmit motion received from an actuator to a shaft (e.g., receivedfrom trigger 1034 and transmitted to blade shaft 1032). In otherexamples a motion transfer body within this disclosure need not bespool-shaped, such as in examples where the spool 1064 does not need tobe rotatable.

As shown in FIG. 4A, when the lever 1024 is in a distal position (e.g.,default position, open position of jaws 1012), the drive body 1052 ispositioned within the channel formed by interior surface 1098 of outerhub 1060. Most of the body portion 1072 of the drive body 1052 is withinthe channel of the outer hub 1060. The drive shaft 1026 is in a firstposition with respect to housing 1014 as it is not being pulledproximally (e.g., unactuated position, non-retracted position) by clip1056 and is within the opening in the stabilizing flange 1021. As aresult, the jaws 1012 are in an open position as shown in FIG. 1A.

As shown in FIG. 4B, when the lever 1024 is being moved proximally, thelever 1024 pulls the bottom end of the drive link 1046 in a proximaldirection with respect to housing 1014 via the coupling link 1042. Thedrive link 1046 is connected to the drive body 1052 at the neck portion1086 and pushes on the drive surface 1090A of the collar 1088, causingthe drive body 1052 to move in a proximal direction longitudinally withrespect to the housing 1014 (see FIG. 5A for a closeup view of the drivebody 1052). As a result, a greater portion of the body portion 1072,including the window portion 1082, of the drive body 1052 moves out thechannel of the outer hub 1060. When the drive body 1052 is pulledproximally, the force-limiting spring 1054 and the clip 1056 move alongwith the drive body 1052 in the same positions with respect to the drivebody 1052.

In other words, the distal spring seat 1076 drives the force-limitingspring 1054, which drives the clip 1056, along with the drive body 1052.When the drive force supplied by the drive link 1046 is less than thepreload force in the force-limiting spring 1054, the force-limitingspring 1054 acts like a rigid body and the ends of the force-limitingspring 1054 move together. As such, the drive body 1052 moves proximallywith respect to the housing 1014 and the clip 1056 moves proximally withrespect to the housing 1014. Because the clip 1056 is longitudinallylocked to the drive shaft 1026 at the first vertical slot 1070A and thesecond vertical slot 1070B, the drive shaft 1026 also moves proximallywith respect to the housing 1014. As the drive shaft 1026 movesproximally (e.g., is retracted), the end effector 1002 becomes actuated.In this example, actuating the end effector 1002 includes the jaws 1012beginning to close.

In other words, in the situation of FIG. 4B, the lever 1024 may beclosed due to user input to close jaws 1012. Movement of the lever 1024causes movement of drive body 1052. Closing lever 1024 causes thecoupling link 1042 to pull drive link 1046 proximally with respect tohousing 1014, which causes longitudinal translation of drive body 1052in the proximal direction. Moving the drive body 1052 proximally causeslongitudinal translation of the drive shaft 1026 in the proximaldirection because the drive body 1052 and the drive shaft 1026 areconnected via the clip 1056. As a result of the movement of the driveshaft 1026, a mechanism on the jaws 1012 is actuated, closing the jaws1012. As shown in the illustrative example, while the drive link 1046drives the drive body 1052 longitudinally, the drive body 1052 can stillbe free to rotate inside the yoke of the drive link 1046 and can rotaterelative to the drive link 1046. However, in some examples, the rotationaspect may be omitted.

In the illustrative example, at any time during use, regardless ofwhether the jaws 1012 are opened or closed, the jaws 1012 can berotated. For example, rotation of the rotational actuator 1030 rotatesthe outer hub 1060, which beneficially transfers rotational motion torotate the outer shaft 1028 and the drive body 1052. Because drive body1052 is locked (e.g., constrained) to the drive shaft 1026 via the clip1056, the drive shaft 1026 can also rotate with the outer shaft 1028.Thus, the outer shaft 1028 and the drive shaft 1026 can be rotationallylocked together (e.g., rotationally constrained) at a proximal end offorceps 1000, and as is described further herein, the outer shaft 1028and the drive shaft 1026 can also be rotationally locked or constrainedtogether at a distal end of the forceps 1000 (such as by guide 2014shown in the forceps 2000 of FIG. 20A, described further herein).

Further, first horizontal slot 1069A and second horizontal slot 1069B indrive shaft 1026 can engage and rotate cross pin 1066 when the driveshaft 1026 is rotated, to rotate blade shaft 1032 and spool 1064. Thus,the drive shaft 1026 and blade assembly (1032, 1032A) can berotationally constrained (e.g., fixed, locked together) at a proximalend of forceps 1000 via cross pin 1066 (FIG. 2 , FIG. 4A). In otherwords, the blade assembly (1032, 1032A) can be rotationally constrainedto the drive shaft 1026 at a longitudinal location along thelongitudinal axis A1 (FIG. 1B) that is proximal of the jaws 1012 andproximal of the drive body 1052.

If actuation is complete, to return the jaws 1012 to the unactuatedstate of FIG. 4A, the lever return spring 1040 can act on the lever 1024to return (e.g., bias) the lever 1024 to the default position (e.g.,distal position). Since the lever 1024 is coupled to the drive shaft1026 by a series of linkages, described herein with reference to atleast FIGS. 15A and 15B, the lever return spring 1040 also returns thedrive shaft 1026 and thereby the jaws 1012 to a default position (FIG.15A), which in the present example is an open position. As shown in thecondition of FIG. 4C, it is possible that jaws 1012 may become stuck orcaught on an anatomical feature or another medical device in the patientwhen the lever 1024 is being moved proximally. In such a situation, thejaws 1012 may not be able to close completely. However, the drive motiontransfer assembly 1051 of forceps 1000 includes a force limiting featurethat prevents the drive shaft 1026 from being retracted to the pointwhere the jaws 1012 become damaged by the additional input force F1 fromthe user being transmitted to the jaws 1012. The forceps 1000 can becapable of achieving a force limiting state (e.g., an over-travel state)in instances where the lever 1024 is being moved proximally and the jaws1012 get stuck in an open or partially open position and the usercontinues to apply a force to the lever 1024.

To prevent damage to the jaws 1012, the force-limiting spring 1054 canbe configured to absorb excess force applied to the lever 1024 insteadof transferring the excess force to the jaws. For example, theforce-limiting spring 1054 can extend from a first end portion to asecond end portion and can be in a preloaded state between the distalspring seat 1076 and a distal end surface 1105 of the clip 1056. Theforce-limiting spring 1054 can push the clip 1056 in a proximaldirection such that the clip 1056 contacts and is supported by a clipsupport surface (e.g., clip support surface 1081, FIG. 5A) of the bodyportion 1072 adjacent a proximal end of the window portion 1082. Theclip support surface (1081, FIG. 5A) can function as a proximal stop forthe clip 1056. With the force-limiting spring 1054 in compression, thedistal spring seat 1076 can be configured to receive a first springforce from the distal end portion of the force-limiting spring 1054, andthe clip 1056 can be configured to receive a second spring force fromthe proximal end portion of the force-limiting spring 1054. The drivebody 1052 can include the clip support surface 1081 configured totransmit the first force to the second surface (e.g., proximal endsurface 1103) of the clip 1056 when the force-limiting spring 1054,under a load, such as a preload, drives the clip 1056 against the clipsupport surface 1081.

With continued reference to FIG. 4C, in an example of force limiting,the lever 1024 is moved to a proximal position by the user, exertingforce on the drive link 1046 and pulling the bottom end of drive link1046 further in a proximal direction, although the jaws 1012 are blockedfrom closing further. Consequently, the drive link 1046 exerts moreforce on the drive surface 1090A of the collar 1088, moving the drivebody 1052 further proximally with respect to housing 1014 and the drivebody 1052 moves farther proximally out of the interior surface 1098 thatforms a passageway 1098A (FIG. 3C) of the outer hub 1060. The outer hub1060 can be constrained from axial movement with respect to the housing1014 by proximal housing flange 1060 a and distal flange 1060B of theouter hub 1060 which can be captured by a portion of housing 1014. Asthe drive body 1052 moves proximally, the distal spring seat 1076 of theanchor portion 1074 of the drive body 1052 pushes on a distal end of theforce-limiting spring 1054. However, because the jaws 1012 are unable toclose further, the drive shaft 1026 cannot move proximally along withthe drive body 1052. Further, because the clip 1056 is locked to driveshaft 1026, the clip 1056 cannot move proximally with respect to housing1014 either. Thus, the drive body 1052 moves proximally relative to theclip 1056 and the drive shaft 1026 by sliding (e.g., linear motion,longitudinal motion or translating) proximally relative to the clip1056.

The clip 1056, by remaining fixed with respect to the drive shaft 1026,effectively moves distally relative to the drive body 1052 within thefirst window 1084A and the second window 1084B of the window portion1082. As such, the force-limiting spring 1054 becomes more compressedbetween the distal spring seat 1076 and the distal end surface of theclip 1056 when the force exerted on the drive link 1046 is greater thana preload of the force-limiting spring 1054. The user can feel thisforce limiting feature as an increase in force on the lever 1024 due tothe additional compression of the force-limiting spring 1054 over thepreloaded state, however, the lever 1024, which is no longertransferring motion to the drive shaft, is still movable.

In other words, the lever 1024 can be fully moved into a proximalposition, moving the drive body 1052 proximally in the housing 1014 asfar as the drive shaft 1026 will go. At the same time, the jaws 1012 canbecome locked in an open position (e.g., caught on something),preventing the drive shaft 1026 from moving even though the lever 1024is being moved proximally. Because the drive shaft 1026 cannot moveproximally in the housing 1014, the clip 1056 cannot move proximallywith respect to the housing 1014. However, because the clip 1056 canslide within the window portion 1082, the drive body 1052 is able tomove (e.g., slide, translate) proximally with respect to the clip 1056,changing the position of the clip 1056 within the window portion 1082.As the drive body 1052 moves with respect to the clip 1056, theforce-limiting spring 1054 compresses and absorbs the force exerted onthe lever 1024. Because moving the drive shaft 1026 causes the jaws 1012to close, the ability to prevent the drive shaft 1026 from moving whenthe jaws 1012 are unable to close prevents the jaws 1012 from becomingdamaged when a user is unaware of the jaws 1012 being stuck open and theuser continues to pull the lever 1024 proximally to close the jaws 1012.

In addition to the clamping system shown and described in FIGS. 4A, 4Band 4C, FIGS. 4A, 4B and 4C also illustrate components that can be usedto actuate another system, such as, but not limited to, a cutting systemfor actuating a blade assembly (e.g., blade shaft 1032, FIG. 3C).Additional aspects of the cutting system are further describedthroughout this disclosure and in FIGS. 15A, 15B, 16A, 16B inparticular.

As shown in the illustrative example of FIGS. 4A, 4B and 4C, the spool1064 can be positioned around a proximal end of the drive shaft 1026proximal to the drive body 1052 and can be connected to a proximal endof the blade shaft 1032 via cross pin 1066. Thus, the blade assembly(1032, 1032A) is attached to a proximal end of the drive shaft 1026 viathe cross pin 1066 extending through the first horizontal slot 1069A andthe second horizontal slot 1069B. The spool 1064 can be within thehousing 1014 distal to the stabilizing flange 1021. The spool 1064 canbe axisymmetric and can be longitudinally movable with respect to thedrive shaft 1026. In an alternate example, where the drive shaft 1026and blade shaft 1032 do not need to rotate, the spool 1064 can be anon-spool shaped body.

The trigger 1034 can be connected to the spool 1064. A proximal end ofthe trigger 1034 can include one or more legs, in this example, two legsforming a yoke, that fit around and can be connected to the spool 1064.The spool 1064 can rotate relative to trigger 1034 to allow the driveshaft 1026 to rotate. The trigger return spring 1068 can be a helicalcompression spring positioned on the drive shaft 1026 between a distalend of spool 1064 and a proximal end of drive body 1052. The triggerreturn spring 1068 can be assembled by loading the trigger return spring1068 onto the drive shaft 1026 and then positioning the spool 1064 ontothe drive shaft 1026 to connect trigger 1034 to the blade shaft 1032. Insome examples, the trigger return spring 1068 can be any suitablebiasing element such as an elastomeric component, elastomeric band orelastomeric block that can be strained and elastically return to itsoriginal form, or substantially original form.

To facilitate extension and retraction of the blade shaft 1032, thecross pin 1066 can move within the first horizontal slot 1069A and thesecond horizontal slot 1069B of the drive shaft 1026. In some examples,the dimensioning of first horizontal slot 1069A and the secondhorizontal slot 1069B can be such that they act as guide rails for thecross pin 1066 to control longitudinal reciprocation of spool 1064. Insuch an example, the spool 1064 can be guided by the drive shaft 1026.The first horizontal slot 1069A can extend into a first side of thedrive shaft 1026, and the second horizontal slot 1069B can extend into asecond side of the drive shaft 1026 across from or opposing the firsthorizontal slot 1069A. The first horizontal slot 1069A and the secondhorizontal slot 1069B are near a proximal end of the drive shaft 1026.As such, the cross pin 1066 can extend through the spool 1064, the firsthorizontal slot 1069A of the drive shaft 1026, the blade shaft 1032, andthe second horizontal slot 1069B of the drive shaft 1026. The second arm1034D is hidden in FIGS. 4A, 4B and 4C. The spool 1064 can include aproximal trigger return spring seat 1101 at a distal end of the spool1064. As such, the trigger return spring 1068 can be positioned on thedrive shaft 1026 between a proximal end of the drive body 1052, or thesecond distal spring seat 1091, and a distal end of the spool 1064, orproximal trigger return spring seat 1101. In an alternate example, asecond passageway 1064A (FIG. 2 ) in the spool 1064 can ride on thedrive shaft 1026 and be guided for longitudinal movement along the driveshaft 1026.

The cutting system is further illustrated and further described in FIGS.15A, 15B, 16A, 16B, however, as a general overview, the cutting systemcan operate as described in the following manner. Compressing a distalend of the trigger 1034 can move a proximal end of the trigger 1034 in adistal direction with respect to the housing 1014, which can cause thespool 1064 to move distally. The spool 1064 can push against a proximalend of the trigger return spring 1068. The preload of the trigger returnspring 1068 can be overcome such that trigger return spring 1068compresses. The spool 1064, connected to the blade shaft 1032 by thecross pin 1066, can cause the blade shaft 1032 to move longitudinally ina distal direction via the cross pin 1066 traveling along, or within,the first horizontal slot 1069A and the second horizontal slot 1069B ofthe drive shaft 1026, causing blade 1032A (FIG. 2 ) to protrude from adistal end of the drive shaft 1026. When the trigger 1034 is notcompressed, the trigger return spring 1068 can expand, pushing the spool1064 and the blade shaft 1032 in a proximal direction to a position inwhich the blade 1032A (FIG. 2 ) does not protrude from the drive shaft1026.

FIG. 5A is an isometric view of an example drive shaft motion transferassembly 1051 that can be used in the forceps 1000 of FIG. 1A, includingthe drive body 1052, the force-limiting spring 1054, the clip 1056 andthe drive shaft 1026. FIG. 5B is an isometric view of the drive body1052 and the clip 1056 on the drive shaft 1026 with the force-limitingspring 1054 in cross-section. FIG. 5C is an exploded view of the drivebody 1052, the clip 1056, and the drive shaft 1026. FIGS. 5A, 5B, and 5Cwill be discussed together. The motion transfer assembly 1051 serves totransfer a force input F1 (FIG. 1B) applied by a user at lever 1024and/or a rotational input R1 applied by a user at rotational actuator1030, to the end effector 1002 (FIG. 1B).

The motion transfer assembly 1051 of the example of FIGS. 5A and 5B isdescribed as follows. The drive shaft 1026 can include the firstvertical slot 1070A and the second vertical slot 1070B. The drive body1052 can include the body portion 1072, the anchor portion 1074(including the distal spring seat 1076), and the window portion 1082(including the first window 1084A and the second window 1084B), surfacesto interface with the drive link 1046, including the collar 1088, theneck portion 1086 and the distal collar 1089 (e.g. a distal surface, aproximally-facing distal face). The clip 1056 can include a clip body1102 having a proximal end surface 1103 and a distal end surface 1105(e.g., a proximal spring seat 1104), a clip slot 1106, clip notches1108A and 1108B (including a first clip notch 1108A and a second clipnotch 1108B). The window portion 1082 can further include retaining ribs1110A and 1110B (including a first retaining rib 1110A and a secondretaining rib 1110B) and window notches 1112A and 1112B (including afirst window notch 1112A and a second window notch 1112B). The driveshaft 1026, drive body 1052, force-limiting spring 1054, and the clip1056 can have the same structure and function as described with respectto FIGS. 1A-4C.

The clip 1056 can have the clip body 1102 having the proximal endsurface 1103 opposite a distal end surface 1105. The distal end surface1105 of the clip body 1102 can provide the proximal spring seat 1104 forsupporting the force-limiting spring 1054. The clip slot 1106 can be aslot that extends into the clip body 1102 from a bottom of the clip body1102. The clip slot 1106 can have a width about equal to or slightlywider than the length from first vertical slot 1070A to second verticalslot 1070B of the drive shaft 1026. In an alternate example where theclip 1056 is flexible, the clip slot 1106 may have a width slightlynarrower than the length from first vertical slot 1070A to secondvertical slot 1070B of the drive shaft 1026. The clip notches 1108A and1108B can extend into the clip body 1102 from the clip slot 1106. Thefirst clip notch 1108A can extend into the clip body 1102 from a firstside of the clip slot 1106 at a top of the clip slot 1106, and thesecond clip notch 1108B can extend into the clip body 1102 from a secondside of the clip slot 1106 at the top of the clip slot 1106. As such,the second clip notch 1108B can extend into the clip body 1102 from theclip slot 1106 opposite first the clip notch 1108A.

The window portion 1082 can include the first window 1084A extendingthrough a first side of body portion 1072 and the second window 1084Bextending through a second side of the body portion 1072 opposite thefirst window 1084A. The first retaining rib 1110A can extend into thefirst window 1084A from a top of the body portion 1072. The firstretaining rib 1110A can extend from an upper portion of the top of thebody portion 1072 such that the first retaining rib 1110A forms a firstlip at the top of the body portion 1072. The second retaining rib 1110Bcan extend into the second window 1084B from a top of the body portion1072. The second retaining rib 1110B can extend from an upper portion ofthe top of the body portion 1072 such that the second retaining rib1110B forms a second lip at the top of body portion 1072. The firstwindow notch 1112A can be included as part of the first window 1084A ata distal end of the first retaining rib 1110A. The second window notch1112B be included in as part of the second window 1084B at a distal endof the second retaining rib 1110B. In alternate examples, the firstwindow notch 1112A and the second window notch 1112B can be positionedanywhere along the first retaining rib 1110A and the second retainingrib 1110B, respectively. In a potentially beneficial example, placementof the first and second window notches 1112A and 1112B may be far enoughdistal such that the clip 1056 never aligns with the window notches1112A and 1112B as assembled, even when the force limiting spring 1054is compressed. Preventing the clip 1056 from aligning with the windownotches 1112A and 1112B prevents the clip 1056 from egressing out of thewindow notches 1112A and 1112B.

When the drive body 1052 is on the drive shaft 1026, the clip 1056 canbe positioned on the window portion 1082 of the drive body 1052. Theclip slot 1106 can fit around drive body 1052 at the window portion 1082and can fit around the drive shaft 1026 at the first vertical slot 1070Aand the second vertical slot 1070B such that the clip 1056 fits withinand is accepted by the first vertical slot 1070A and the second verticalslot 1070B of the drive shaft 1026. A proximal end of the force-limitingspring 1054 can contact the proximal spring seat 1104 of the clip 1056.A distal end of the force-limiting spring 1054 can contact the distalspring seat 1076. The distance between the proximal spring seat 1104 andthe distal spring seat 1076, being less than a length of theforce-limiting spring 1054, causes the force-limiting spring 1054 to becompressed and places a preload upon the force-limiting spring 1054. Thefirst clip notch 1108A can fit around first retaining rib 1110A. Thesecond clip notch 1108B can fit around second retaining rib 1110B. Theclip 1056 can move longitudinally within the first window 1084A and thesecond window 1084B at window portion 1082 and along the first retainingrib 1110A and the second retaining rib 1110B.

The first vertical slot 1070A and the second vertical slot 1070B on thedrive shaft 1026 longitudinally and rotationally lock the clip 1056 tothe drive shaft 1026. The clip notches 1108A and 1108B and the retainingribs 1110A and 1110B can fit together to retain the clip 1056 to boththe drive body 1052 and the drive shaft 1026, preventing the clip 1056from backing out of first vertical slot 1070A, second vertical slot1070B, and the window portion 1082, and rotationally lock the clip 1056to drive body 1052. However, some instances (e.g., a force limitingstate), as described herein, the drive body 1052 is still capable ofmoving longitudinally with respect to the clip 1056 such that the clip1056 moves longitudinally with respect to drive body 1052 within thefirst window 1084A and the second window 1084B along the retaining ribs1110A and 1110B. As a result, the drive body 1052 can movelongitudinally relative to the drive shaft 1026 The clip 1056 isprevented from backing out or popping off drive body 1052 and the driveshaft 1026 while drive body 1052 moves longitudinally relative to theclip 1056 and the drive shaft 1026. In the assembled state, the clip1056 can be misaligned with the window notches 1112A and 1112B butaligned with first and second vertical slots 1070A and 1070B (FIG. 5C).

In this arrangement, the clip 1056 can be fixed to the drive shaft 1026and slidably coupled to the drive body 1052. The rotational motion canbe delivered from the drive body 1052 through the clip 1056 to the driveshaft 1026, and the linear motion can be delivered from the drive body1052 indirectly through the force-limiting spring 1054 to the clip 1056and from the clip 1056 to the drive shaft 1026 to translate the driveshaft 1026.

In other words, the clip 1056 can be coupled to the drive body 1052 andthe drive shaft 1026 to rotationally fix the drive body 1052 to thedrive shaft 1026. The drive body 1052 can be configured to transfer arotational input received from the rotational actuator 1030 into arotational motion of the clip 1056, and the clip 1056 can be configuredto transfer the rotational motion of the clip 1056 into a rotationalmotion of the drive shaft 1026.

As shown in FIG. 5A, the input surfaces to receive an input from thedrive link 1046 (FIGS. 3A, 3B, 3C) can include the collar 1088 (e.g.,first face), the neck portion 1086 (e.g., minor diameter surface) andthe distal collar 1089 (e.g., distal face). The collar 1088, the neckportion 1086 and the distal collar 1089 can form a spool portion of thedrive body 1052. In some examples, the spool portion (e.g., 1088, 1086and 1089) can be an axisymmetric spool portion. In some examples, adistal face 1088B of the proximal collar 1088 and a proximal face 1089Aof the distal collar 1089 are planar. In some examples, a distal face1088B of the proximal collar 1088 and a proximal face 1089A of thedistal collar 1089 are parallel. In some examples, the spool portionallows for rotational displacement of the drive body 1052 relative tothe drive link 1046.

FIG. 6A is a partially exploded view of the motion transfer assembly1051 including the first example of the drive body 1052 and the firstexample of the clip 1056 showing the drive body 1052 on the drive shaft1026. FIG. 6B is an isometric view of the first example of the drivebody 1052 and the first example of the clip 1056 showing theforce-limiting spring 1054 compressed and the clip 1056 being assembledonto the drive shaft 1026 along an insertion direction II. FIG. 6C is aview of the first example of the drive body 1052 and the first exampleof the clip 1056 in a force limiting state (e.g., an over-travelposition). FIGS. 6A, 6B, and 6C will be discussed together to illustratehow the drive body 1052, the force-limiting spring 1054, and the clip1056 are assembled onto the drive shaft 1026.

The drive shaft 1026 can include the first vertical slot 1070A and thesecond vertical slot 1070B. The drive body 1052 can include the bodyportion 1072, the anchor portion 1074, and the window portion 1082(including the first window 1084A and the second window 1084B). The clip1056 can include the clip body 1102, the proximal spring seat 1104, theclip slot 1106, the clip notches 1108A and 1108B (including the firstclip notch 1108A and the second clip notch 1108B). The window portion1082 can further include the retaining ribs 1110A and 1110B (includingfirst retaining rib 1110A and second retaining rib 1110B) and the windownotches 1112A and 1112B (including first window notch 1112A and secondwindow notch 1112B). The drive shaft 1026, the drive body 1052, theforce-limiting spring 1054, and the clip 1056 can have the samestructure and function as described with respect to FIGS. 1A-5C.

To assemble the drive body 1052, the force-limiting spring 1054 and theclip 1056 onto the drive shaft 1026, first the drive body 1052 can bepositioned on the drive shaft 1026. Second, the force-limiting spring1054 can be positioned on the drive body 1052 around the body portion1072 and the window portion 1082 of drive body 1052. Third, theforce-limiting spring 1054 can be slid onto the drive body 1052 from theproximal ends of the drive shaft 1026 and the drive body 1052. Fourth,the force-limiting spring 1054 can be compressed against the anchorportion 1074 such that the force-limiting spring 1054 is not positionedaround the window notches 1112A and 1112B, as shown in FIG. 5C. Thedrive body 1052 can be positioned on the drive shaft 1026 such thatfirst vertical slot 1070A and second vertical slot 1070B in the driveshaft 1026 are aligned with the window notches 1112A and 1112B in thewindow portion 1082 of the drive body 1052. The first vertical slot1070A and the second vertical slot 1070B can be visible through thefirst window 1084A and the second window 1084B when the first verticalslot 1070A and the second vertical slot 1070B are aligned with thewindow portion 1082. The clip 1056 can then be positioned onto thewindow portion 1082 of drive body 1052 at the window notches 1112A and1112B such that the clip 1056 also extends through first vertical slot1070A and second vertical slot 1070B in the drive shaft 1026, as shownin FIG. 6B. In this method of assembly the clip 1056 does not need toflex, stress or deform during assembly, in order to be installed.

As shown in FIG. 6C, the compression force is then removed from theforce-limiting spring 1054, and the force-limiting spring 1054 expandstowards a preloaded state between anchor portion 1074 and the clip 1056,pushing the clip 1056 longitudinally within the window portion 1082until the clip 1056 is against the clip support surface 1081 of bodyportion 1072 adjacent a proximal end of the window portion 1082, orproximal ends of first window 1084A and second window 1084B.

The clip notches 1108A and 1108B can engage retaining ribs 1110A and1110B (e.g., or another retention element) as the clip 1056 is movedproximally with respect to the window notches 1112A and 1112B. As shownin FIG. 6C, which also illustrates the position of the clip 1056relative to the drive body 1052 in the force limiting or over-travelstate, the drive body 1052 moves proximally relative to the clip 1056.As such, the clip 1056 can move longitudinally within the first window1084A and the second window 1084B at the window portion 1082. The clip1056 can travel within the window portion 1082. The clip 1056 cannottravel longitudinally outside of the window portion 1082 because thebody portion 1072 on either side of the window portion 1082 can stop theclip 1056.

The window notches 1112A and 1112B can function as slots that allow theclip 1056 to be assembled onto the retaining ribs 1110A and 1110B.Keeping the clip 1056 within the length of the retaining ribs 1110A and1110B is desirable as the fit between the clip notches 1108A and 1108Band retaining ribs 1110A and 1110B retains the clip 1056 on the drivebody 1052 and the drive shaft 1026. Positioning the clip 1056 onto thewindow portion 1082 and within first vertical slot 1070A and secondvertical slot 1070B rotationally locks the clip 1056 to the drive body1052 and rotationally and longitudinally locks the clip 1056 to thedrive shaft 1026. The fit between the retaining ribs 1110 and 1110B andthe clip notches 1108A and 1108B can help to transmit a rotationaltorque between the drive body 1052 and the clip 1056. Compressing theforce-limiting spring 1054 to place the clip 1056 on drive body 1052provides the force-limiting spring 1054 a preload, which affects theamount of force necessary to initiate the force limiting state (e.g.,the over-travel state). The higher the preload on the force-limitingspring 1054, the more force a user must apply before the force limitingstate is initiated.

FIG. 7A is an isometric view of a second example of a motion transferassembly 1251 showing a drive body 1252, a clip 1256, and a crosssection of a spring 1254 on a drive shaft 1226. FIG. 7B is an explodedview of the drive body 1252 and the clip 1256, the spring 1254 and thedrive shaft 1226. The drive body 1252 can include a body portion 1272, awindow portion 1282 and an anchor portion 1274. FIGS. 7A and 7B arediscussed together and include features to improve clip 1256 retentionto prevent backout of a clip 1256 and for torque transfer from a drivebody 1252 to a clip 1256. One benefit of the example of FIGS. 7A and 7Bincludes a duplication of slots and retaining ribs to increase thesurface that facilitates torque transfer and prevents clip 1256 backout.

The window portion can include a first window 1284A, a second window1284B, a first retaining rib 1210A, a second retaining rib 1210B, athird retaining rib 1210C, a fourth retaining rib 1210D, a first windownotch 1212A, a second window notch 1212B, a third window notch 1212C,and a fourth window notch 1212D).

The clip 1256 can include a clip body 1202, a proximal spring seat 1204,a clip slot 1206, a first clip notch 1208A, a second clip notch 1208B, athird clip notch 1208C, and a fourth clip notch 1208D. The drive shaft1226 includes a first vertical slot 1270A and a second vertical slot1270B.

The drive body 1252 has the clip 1256 positioned on the drive body 1252and connected to the drive shaft 1226, which extends through the drivebody 1252. The spring 1254 is positioned around the drive body 1252. Thedrive body 1252 has generally the same structure and function as thedrive body 1252 described with respect to FIGS. 1A-6C, including thebody portion 1272 and the window portion 1282 having the first window1284A and the second window 1284B. However, the drive body 1252 has thethird retaining rib 1210C, the fourth retaining rib 1210D, the thirdwindow notch 1212C, and the fourth window notch 1212D at a bottom of thedrive body 1252, and the anchor portion 1274 can be cylindrical.

The first retaining rib 1210A can extend into the first window 1284Afrom a top of the body portion 1272. The first retaining rib 1210A canextend from an upper portion of the top of the body portion 1272 suchthat the first retaining rib 1210A forms a first lip at the top of thebody portion 1272. The second retaining rib 1210B can extend into thesecond window 1284B from a top of the body portion 1272. The secondretaining rib 1210B can extend from an upper portion of the top of bodyportion 1272 such that second retaining rib 1210B forms a second lip atthe top of the body portion 1272. The first retaining rib 1210A and thesecond retaining rib 1210B can form a pair of retaining ribs. The thirdretaining rib 1210C can extend into the first window 1284A from a bottomof the body portion 1272. The third retaining rib 1210C can extend froma lower portion of the bottom of the body portion 1272 such that thethird retaining rib 1210C forms a third lip at the bottom of the bodyportion 1272. The fourth retaining rib 1210D can extend into the secondwindow 1284B from a bottom of the body portion 1272. The fourthretaining rib 1210D can extend from a lower portion of the bottom of thebody portion 1272 such that the fourth retaining rib 1210D forms afourth lip at the bottom of the body portion 1272. The third retainingrib 1210C and the fourth retaining rib 1210D can form a pair ofretaining ribs. The first window notch 1212A can be part of the firstwindow 1284A at a distal end of the first retaining rib 1210A. Thesecond window notch 1212B can be part of the second window 1284B at adistal end of the second retaining rib 1210B. The third window notch1212C can be part of the first window 1284A at a distal end of the thirdretaining rib 1210C. The fourth window notch 1212D can be part of thesecond window 1284B at a distal end of the fourth retaining rib 1210D.

The clip 1256 can have generally the same structure and function as theclip 1056 described with respect to FIGS. 1A-6C, including the clip body1202, the proximal spring seat 1204, and the clip slot 1206. However, insome examples the clip 1256 can further include the third clip notch1208C and the fourth clip notch 1208D. The first clip notch 1208A canextend into the clip body 1202 from a first side of the clip slot 1206at a top of the clip slot 1206, and the second clip notch 1208B canextend into the clip body 1202 from a second side of the clip slot 1206at the top of the clip slot 1206. As such, the second clip notch 1208Bcan extend into the clip body 1202 from the clip slot 1206 opposite thefirst clip notch 1208A. The third clip notch 1208C can extend into theclip body 1202 from the first side of the clip slot 1206 near a bottomof the clip slot 1206, and the fourth clip notch 1208D can extend intothe clip body 1202 from the second side of the clip slot 1206 near thebottom of the clip slot 1206. As such, the third clip notch 1208C isspaced from the first clip notch 1208A, and the fourth clip notch 1208Dcan extend into the clip body 1202 from the clip slot 1206 opposite thethird clip notch 1208C and is spaced from the second clip notch 1208B.The drive shaft 1226 that receives the clip can be the same as orsimilar to the drive shaft 1226 described with respect to FIGS. 1A-6C,including the first vertical slot 1270A and the second vertical slot1270B.

When the drive body 1252 is on the drive shaft 1226, the clip 1256 canbe positioned on the window portion 1282 of the drive body 1252. Theclip slot 1206 can fit around the drive body 1252 at the window portion1282 and can fit around the drive shaft 1226 at the first vertical slot1270A and the second vertical slot 1270B such that the clip 1256 fitswithin and is accepted by the first vertical slot 1270A and the secondvertical slot 1270B of the drive shaft 1226. A proximal end of thespring 1254 can contact the proximal spring seat 1204 of the clip 1256.The first clip notch 1208A can fit around the first retaining rib 1210Asuch that the first retaining rib 1210A fits within the first clip notch1208A. The second clip notch 1208B can fit around the second retainingrib 1210B such that the second retaining rib 1210B fits within thesecond clip notch 1208B. The third clip notch 1208C can fit around thethird retaining rib 1210C such that the third retaining rib 1210C fitswithin the third clip notch 1208C. The fourth clip notch 1208D can fitaround the fourth retaining rib 1210D such that the fourth retaining rib1210D fits within the fourth clip notch 1208D. The clip 1256 can movelongitudinally within the first window 1284A and the second window 1284Bat the window portion 1282 along the first retaining rib 1210A, thesecond retaining rib 1210B, the third retaining rib 1210C, and thefourth retaining rib 1210D.

The clip notches 1208A, 1208B, 1208C, and 1208D and the retaining ribs1210A, 1210B, 1210C, and 1210D can fit together to retain the clip 1256to the drive body 1252 and the drive shaft 1226 and rotationally lockthe clip 1256 to the drive body 1252 while allowing the clip 1256 tomove longitudinally within the first window 1284A and the second window1284B along the retaining ribs 1210A, 1210B, 1210C, and 1210D. As aresult, the clip 1256 is prevented from popping off the drive body 1252and the drive shaft 1226 while being capable of longitudinal movementalong axis A1 (FIG. 1B) with respect to the drive body 1252.

Because the drive body 1252 has the third retaining rib 1210C and thefourth retaining rib 1210D that can fit into the third clip notch 1208Cand the fourth the clip notch 1208D of the clip 1256, the clip 1256 canmore evenly and securely be retained on the drive body 1252 and thedrive shaft 1226.

FIG. 8A is an isometric view of a third example of a motion transferassembly 1351 showing a drive body 1352, a clip 1356 and a cross-sectionof spring 1354 on a drive shaft 1326. FIG. 8B is an exploded view of thedrive body 1352, the clip 1356, the spring 1354 and the drive shaft1326. The drive body 1352 can include a body portion 1372, a firstretaining rib 1310A, a second retaining rib 1310B, a third retaining rib1310C, and a fourth retaining rib 1310D. The clip 1356 can include afirst clip notch 1308A, a second clip notch 1308B, a third the clipnotch 1308C, and a fourth the clip notch 1308D. FIGS. 8A and 8B arediscussed together and include features to improve clip 1356 retentionto prevent backout of a clip 1356 and for torque transfer from a drivebody 1352 to a clip 1356. One benefit of the example of FIGS. 8A and 8Bincludes a duplication of slots and retaining ribs to increase thesurface that facilitates torque transfer and prevents clip 1356blackout.

The drive body 1352 can have the clip 1356 positioned on the drive body1352 and coupled to the drive shaft 1326. The spring 1354 can bepositioned around the drive body 1352. The drive body 1352 can havegenerally the same structure and function as the drive body 1252described with respect to FIGS. 7A and 7B, including the body portion1372. However, the first retaining rib 1310A, the second retaining rib1310B, the third retaining rib 1310C, and the fourth retaining rib 1310Dcan be thicker and longer. The first retaining rib 1310A and the secondretaining rib 1310B can extend from all or most of a top of the bodyportion 1372. The third retaining rib 1310C and the fourth retaining rib1310D can extend from all or most of a bottom of the body portion 1372.

The clip 1356 has generally the same structure and function as the clip1256 described with respect to FIGS. 7A and 7B. However, the first clipnotch 1308A, the second clip notch 1308B, the third clip notch 1308C andthe fourth clip notch 1308D can be larger and deeper to accommodate theretaining ribs 1310A, 1310B, 1310C, and 1310D which can be thicker andlonger. The drive shaft 1326 can be the same as the drive shaft 1026described with respect to FIGS. 1A-6C.

The clip notches 1308A, 1308B, 1308C, and 1308D and the retaining ribs1310A, 1310B, 1310C, and 1310D can fit together to retain the clip 1356to the drive body 1352 and the drive shaft 1326 and rotationally lockthe clip 1356 to the drive body 1352 while allowing the drive body 1352to move longitudinally relative to the clip 1356 along the retainingribs 1310A, 1310B, 1310C, and 1310D. As a result, the clip 1356 can beinhibited or prevented from popping off the drive body 1352 and thedrive shaft 1326 while being capable of longitudinal movement withrespect to the drive body 1352.

FIG. 9A is an isometric view of a fourth example of a motion transferassembly 451 showing a drive body 1452, a clip 1456 and a cross-sectionof a spring 1454 on a drive shaft 1426. FIG. 9B is an exploded view ofthe drive body 1452, the clip 1456, the spring 1454 and the drive shaft1426. The drive body 1452 can include a body portion 1472, a windowportion 1482 and struts 1418. The window portion 1482 can include afirst window 1484A, a second window 1484B, a first retaining rib 1410A,a second retaining rib 1410B, a third retaining rib 1410C, a fourthretaining rib 1410D, a first window notch 1412A, a second window notch1412B, a third window notch 1412C, and a fourth window notch 1412D. Thestruts 1418 can include a first strut 1418A and a second strut 1418B.The clip 1456 can include a clip body 1402, a clip slot 1406, a firstclip notch 1408A, a second clip notch 1408B, a third clip notch 1408C,and a fourth clip notch 1408D. FIGS. 9A and 9B are discussed togetherand include features to improve clip 1456 retention to prevent backoutof a clip 1456 and for torque transfer from a drive body 1452 to a clip1456. One benefit of the example of FIGS. 9A and 9B includes aduplication of slots and retaining ribs to increase the surface thatfacilitates torque transfer and prevents clip 1456 backout.

The drive body 1452 has the clip 1456 positioned on the drive body 1452and connected to the drive shaft 1426, which can extend through drivebody 1452. The spring 1454 can be positioned around the drive body 1452.

The drive body 1452 can have generally the same structure and functionas the drive body 1352 described with respect to FIGS. 8A and 8B,including the body portion 1472 and the window portion 1482 having thefirst window 1484A, the second window 1484B, the retaining ribs 1410A,1410B, 1410C, and 1410D, and the window notches 1412A, 1412B, 1412C, and1412D. However, the window portion 1482 can include the struts 1418. Atop of the body portion 1472 at the window portion 1482 can be flat.When the top of the body portion 1472 at the window portion 1482 isflat, a close connection between a profile of the retaining ribs 1410A,1410B, 1410C, 1410D and the profile of the respective window notches1412A, 1412B, 1412C and 1412D can be achieved. As such, the firstretaining rib 1410A, the top portion of the body portion 1472, and thesecond retaining rib 1410B form the first strut 1418A. Likewise, abottom of the body portion 1472 can be flat. As such, the thirdretaining rib 1410C, the bottom of the body portion 1472, and the fourthretaining rib 1410D can form the second strut 1418B. Thus, the firstwindow 1484A can be between the first strut 1418A and the second strut1418B at a first side of the body portion 1472, and the second window1484B can be between the first strut 1418A and the second strut 1418B ata second side of the body portion 1472.

Although in some examples it may be beneficial that the top of the bodyportion 1472 at the window portion 1482 are flat, in other embodiments,the top of the body portion 1472 at the window portion 1482 may not beflat or substantially flat. Other shapes may be provided that provide aclose connection between the retaining ribs 1410A, 1410B, 1410C, 1410Dand the respective window notches 1412A, 1412B, 1412C and 1412D.

The clip 1456 can have generally the same structure and function as theclip 1356 described with respect to FIGS. 8A and 8B, including the clipbody 1402, the clip slot 1406, the first clip notch 1408A, the secondclip notch 1408B, the third the clip notch 1408C, and the fourth theclip notch 1408D. However, the clip slot 1406, the first clip notch1408A, and the second clip notch 1408B can be flat at the top while thethird clip notch 1408C and the fourth clip notch 1408D can have flatbottoms to accommodate the struts 1418. The clip slot 1406 can extendinto the clip body 1402 to a lesser extent such that the top of the clipslot 1406, between the first clip notch 1408A and the second clip notch1408B, may be flat.

The drive shaft 1426 can be the same as the drive shaft 1026 describedwith respect to FIGS. 1A-6C. The clip notches 1408A, 1408B, 1408C, and1408D and the retaining ribs 1410A, 1410B, 1410C, and 1410D can fittogether to retain the clip 1456 to the drive body 1452 and the driveshaft 1426 and rotationally lock the clip 1456 to the drive body 1452while allowing the drive body 1452 to move longitudinally relative tothe clip 1456 along the retaining ribs 1410A, 1410B, 1410C, and 1410D.As a result, the clip 1456 can be prevented from popping off the drivebody 1452 and the drive shaft 1426 while being capable of longitudinalmovement with respect to the drive body 1452. Further, because the clipslot 1406 may extend into the clip body 1402 to a lesser extent, theclip body 1402 has more surface area to distribute the load from thespring 1454.

FIG. 10A, FIG. 10A, FIG. 11A and FIG. 11B illustrate an example of howthe drive shaft 1026 and outer shaft 1028 can be constrained to oneanother and to the outer hub 1060 and rotational actuator 1030. FIG. 10Aillustrates a side view of a portion of the forceps of FIG. 1A, inaccordance with at least one example. FIG. 10A includes the outer shaft1028, the outer hub 1060, the housing 1014 and the rotational actuator1030 (shown in phantom). FIG. 10A is a cross-sectional view of therotational actuator 1030 and outer hub 1060 of FIG. 10A along line10A-10A′ but with the rotational actuator 1030 shown in solid, inaccordance with at least one example.

The outer hub 1060 can be located around at least a portion of the drivebody 1052 and the drive shaft 1026. To transfer rotational motion fromthe outer hub 1060 to the drive shaft 1026, the rotational motionreceived from the rotational actuator 1030 can be transferred to theouter hub 1060; transferred from the outer hub 1060 to the drive body1052; transferred from the drive body 1052 to the clip 1056; andtransferred from the clip 1056 to the drive shaft 1026. The rotationalinput received from the rotational actuator 1030 can also be transferredfrom the outer hub 1060 to the outer shaft 1028 to rotate the outershaft 1028. In other examples, the clip 1056 can be omitted and/or thepassageway 1092 (e.g., bore) in the drive body 1052 can be rotationallykeyed to the drive shaft 1026 to transfer the rotational input.

As shown in the combination of FIG. 10A and FIG. 10B, at the proximalportion of the forceps 1000, the rotational actuator 1030 can beconstrained to the outer hub 1060 via a keyed interface. For example,the rotational actuator 1030 can include an actuator-hub keyed interface1033 that is configured to be rotationally constrained to the outer hub1060 having a complimentary actuator-hub keyed interface 1063. The keyedinterface 1033, 1063 can constrain, couple, fix, lock, or limit rotationbetween the rotational actuator 1030 and the outer hub 1060.

In this arrangement, the outer hub 1060 can be configured to receive arotational input from the rotational actuator 1030 such that therotational actuator 1030 and outer hub 1060 can be rotated relative tothe housing 1014. In alternate examples, the rotational actuator 1030can be otherwise attached to the outer hub 1060, such as by integralmolding, adhesive, welding, snap-fit, or any other suitable method. Insome examples, the rotational actuator 1030 can be omitted and the outerhub 1060 can function as an actuator to receive a rotational input froma user directly. The rotational actuator 1030 is merely shown as oneexample of a component to receive a rotational input from a user, anysuitable rotational input device can be provided.

FIG. 11A illustrates a side view of a portion of the forceps of FIG. 1Aincluding the housing 1014, the drive shaft 1026, the outer shaft 1028,the drive body 1052 (having a first portion 1052A and a second portion1052B), the force-limiting spring 1054, the drive link 1046, the outerhub 1060 (shown in phantom), the sleeve 1061, and the jaws 1012 inaccordance with at least one example. FIG. 11B is a cross-sectional viewof the outer hub 1060 and the drive body 1052 of FIG. 11A along line11B-11B′ with the outer hub 1060 shown in solid, in accordance with atleast one example.

To rotationally fix the outer hub 1060 to the drive body 1052, the outerhub 1060 and the drive body 1052 can include a hub-body keyed interface.For example, the outer hub 1060 can include the anti-rotation key 1100,and the drive body 1052 can have a complimentary hub-body keyedinterface, such as rotational keying slot 1078. The rotational keyingslot 1078 can be located at a second portion 1052B of the drive body1052 (e.g., distal portion). In this arrangement, the drive body 1052can be configured to receive a rotational input from the outer hub 1060,supplied to the outer hub 1060 by the rotational actuator 1030 (FIG.10A, 10B).

The anti-rotation key 1100 can include a ridge that extends out of theinterior surface 1098 of the outer hub 1060 into the channel formed bythe interior surface 1098. The anti-rotation key 1100 can be sized tofit within the rotational keying slot 1078 of the outer hub 1060. Therotational keying slot 1078 can accept the anti-rotation key 1100 suchthat the rotational keying slot 1078 can be linearly translated, orotherwise longitudinally moved, along the anti-rotation key 1100 inorder to allow retraction and extension of the drive body 1052 withrespect to the outer hub 1060 and the housing 1014.

In other words, the anti-rotation key 1100 and rotational keying slot1078 constrain the outer hub 1060 and the drive body 1052 rotationally,but the drive body 1052 can still move (e.g., slide, translate) alongthe longitudinal axis A1 relative to the outer hub 1060 when the lever1024 is actuated by a user (FIG. 1B). The longitudinal movement of theouter hub 1060 relative to the drive body 1052 allows the drive body1052 to retract relative to the outer hub 1060 when the lever 1024 isactuated to close the jaws 1012. Such retraction of the drive body 1052results in retraction of the drive shaft 1026, up until a specifiedinput force F1 is applied to the lever 1024 (FIG. 13B) that exceeds thepreload of the force-limiting spring 1054. When the input force F1exceeds the specified input force, the drive body 1052 can continue tomove proximally with respect to the drive shaft 1026 and withoutretracting the drive shaft 1026. Thereby protecting the end effector1002 from receiving an excessive force and becoming damaged.

Traditional forceps sometimes include an outer shaft and an inner shaftthat are only rotationally locked together at a distal end near an endeffector. In such configurations, a rotational input received at arotational actuator only rotates a proximal end of an outer shaft, butnot the inner shaft, to rotate the jaws. In traditional forceps, onlywhen the jaws rotate, does a distal end of the inner shaft receive therotational motion from a connection of the outer shaft to the innershaft proximate the end effector, which eventually causes rotation ofthe inner shaft at a proximal end. A limitation of such a design is thatthe inner shaft and the outer shaft can “wind up” relative to each otherand become damaged as a result.

In contrast, the illustrative forceps 1000 can rotationally constrainthe inner drive shaft 1026 to the outer shaft 1028 at a firstlongitudinal location and a second longitudinal location. In someexamples, the first and second longitudinal locations can include firstand second longitudinal regions. In the illustrative example of FIG.11A, the drive shaft 1026 and the outer shaft 1028 can be rotationallyconstrained at both a proximal portion 1003 of the forceps 1000 and at adistal portion 1005 of the forceps 1000. In this arrangement, the outershaft 1028 and the drive shaft 1026 rotate more evenly together and arethus less likely to become damaged when the jaws 1012 are rotated. Anexample of a connection at the proximal portion 1003 of the forceps 1000is shown and described with continued reference to FIG. 11A and FIG.11B. An example of a connection at the distal portion 1005 of theforceps 1000 is shown and described with reference to FIGS. 20A-25 .

To provide a rotational constraint between the drive shaft 1026 and theouter shaft 1028 at the proximal portion of the forceps 1000, the driveshaft 1026 and the outer shaft 1028 can be rotationally constrained toeach other via the drive body 1052 and the outer hub 1060.

To transfer the rotational motion from the outer hub 1060 to the outershaft 1028, the outer hub 1060 can be fixedly coupled to the outer shaft1028. In an example, a sleeve 1061 can be affixed to both the outer hub1060 and affixed to the outer shaft 1028. The sleeve 1061 can be affixedto an interior surface 1098 of the outer hub 1060, although the sleeve1061 can be affixed to other portions of the outer hub 1060. In someexamples, the sleeve 1061 can be omitted and the outer hub 1060 can bedirectly or otherwise affixed to the outer shaft 1028.

The outer hub 1060 can be longitudinally constrained to the housing 1014while remaining rotatable relative to the housing 1014. This can beaccomplished, for example, by the outer hub 1060 including the proximalhousing flange 1060A and the distal flange 1060B that longitudinallyconstrains a portion of housing 1014 therebetween.

In the illustrative example, the interface between the proximal housingflange 1060A and the housing 1014 can constrain the outer hub 1060 frommoving distally relative to the housing 1014. In a correspondingfashion, the interface between the distal housing flange 1060B and thehousing 1014 can constrain the outer hub 1060 from moving proximallyrelative to the housing 1014. One of the benefits of this arrangement isthat the outer hub 1060 is prevented from moving longitudinally withrespect to the housing 1014, without impacting the ability of the outerhub 1060 to rotate relative to the housing 1014, thereby rotating theend effector 1002. In other examples, the housing 1014 can also oralternatively include a flange to interface with the outer hub 1060 andthereby provide a similar longitudinal constraint. In some examples, asingle flange can provide one or more interfaces with the housing 1014to constrain the outer hub 1060 longitudinally with respect to thehousing. In some examples, instead of the proximal housing flange 1060Aand the distal housing flange 1060B, a single flange can provide theinterface that constrains the outer hub 1060 longitudinally with respectto the housing 1014. For example, by an interface such as a singleflange on the outer hub 1060 or a single flange on the housing 1014 thatis bounded proximally and distally by the other of the outer hub 106 andthe housing 1014. Such alternate geometries are within the scope of thisdisclosure.

To transfer the rotational motion from the outer hub 1060 to the driveshaft 1026, the transfer can occur from the outer hub 1060 through theclip 1056 to the drive body 1052 and the drive shaft 1026. To transferthe rotational motion from the outer hub 1060 to the outer shaft 1028,the outer hub 1060 can be fixedly coupled to the outer shaft 1028.Examples of attachment of an outer hub to an outer shaft are shown anddescribed in FIGS. 9 and 10 .

By rotationally constraining the drive shaft 1026 and the outer shaft1028 to the outer hub 1060 at the proximal end, along with rotationallyconstraining the drive shaft 1026 to the outer shaft 1028 at the distalend proximate the end effector (e.g., jaws 1012), the forceps 1000 canbe less susceptible to torsion of the drive shaft 1026 relative to theouter shaft 1028 along the intermediate portion 1006 between thehandpiece 1001 and the end effector 1002 (FIG. 1B). Reducing torsion inthe drive shaft 1026 and the outer shaft 1028 reduces “wind up” of thedrive shaft 1026 relative to the outer shaft 1028. Limiting “wind up”can improve the ability of the user to control the end effector 1002,thereby limiting undesirable movements (e.g., unwinding, spring back) ofthe end effector 1002. Examples illustrating constraining rotation atthe distal end of the forceps (e.g., distally of the outer hub 1060,proximal of the end effector 1002) are described further herein withrespect to FIGS. 20A-25 .

In some examples, the first longitudinal location (e.g., 1003) can becloser to the handpiece 1001 than to the end effector 1002 and thesecond longitudinal location (e.g., 1005) can be closer to the endeffector 1002 than to the handpiece 1001. The second longitudinallocation (e.g., 1005) can be distal of the first longitudinal location(e.g., 1003). The second longitudinal location (e.g., 1005) can beproximal of the end effector 1002. The second longitudinal location(e.g., 1005) can be proximal of the end effector 1002 coupling to thedrive shaft 1026 or the outer shaft 1028.

The outer shaft 1028 can extend from a proximal end proximate thehandpiece 1001 to a distal end proximate the end effector 1002. In someexamples, the second longitudinal location (e.g., 1005) can be locatedin a range between 75%-95% of a distance D1 from the proximal end to thedistal end of the outer shaft 1028.

FIG. 12 is a partial cross-sectional view of a portion of an exampleforceps 1700 showing another example of a hub-body interface. FIG. 12shows a drive body 1752 with an anchor portion 1774 including anotherexample of an anti-rotation key 1706 and a hub 1760 including arotational keying slot 1710. The drive body 1752, an outer shaft 1728,and a drive shaft 1726 are not shown in cross-section. The forceps 1700can include the drive body 1752 (including the anchor portion 1774having the anti-rotation key 1706), the hub 1760 (including therotational keying slot 1710 and an interior surface 1712), a rotationknob 1730 (e.g., rotational actuator), an outer shaft 1728, and thedrive shaft 1726.

Forceps 1700 can have generally the same structure and function asforceps 1000 described with respect to FIGS. 1A-6C and FIGS. 10A-11B;however, the drive body 1752 can include the anchor portion 1774 (e.g.,distal portion) that has the anti-rotation key 1706, and the hub 1760has the rotational keying slot 1710. The anti-rotation key 1706 can be aprotrusion or ridge that extends out of a side of the anchor portion1774. The anti-rotation key 1706 can be sized to fit within therotational keying slot 1710 of the hub 1760. The hub 1760 can have therotational keying slot 1710 extending into the hub 1760 from theinterior surface 1712.

The rotational keying slot 1710 can accept the anti-rotation key 1706,which is positioned within the rotational keying slot 1710. Theanti-rotation key 1706 can have a length shorter than a length ofrotational keying slot 1710 such that the anti-rotation key 1706 and thedrive body 1752 can be linearly translated along the rotational keyingslot 1710 and the hub 1760. In other words, while the anti-rotation key1706 and the rotational keying slot 1710 prevent relative rotationbetween the hub 1760 and the drive body 1752, the anti-rotation key 1706can act, at in least in part, as a guide for longitudinal movement ofthe drive body 1752 relative to the hub 1760.

The anti-rotation key 1706 and the rotational keying slot 1710 canconnect and rotationally lock the hub 1760 and the drive body 1752.Thus, rotating the rotation knob 1730 rotates the hub 1760, whichrotates the drive body 1752. As a result, rotating the rotation knob1730 rotates both the outer shaft 1728 and the drive shaft 1726together.

In some examples, any of the anti-rotation interfaces described hereincan have the geometries of the keyed interfaces swapped, or the keyedinterfaces can include different interface geometries.

FIG. 13A illustrates a side view of a portion of the forceps 1000 ofFIG. 1A with the lever 1024 in an unactuated position (e.g., drive shaft1026 not retracted, jaws 1012 open), in accordance with at least oneexample. FIG. 13B illustrates a side view of a portion of the forceps1000 of FIG. 1A, with the lever 1024 in an actuated position (e.g.,drive shaft retracted, jaws closed), in accordance with at least oneexample. FIG. 13C illustrates a side view of a portion of the forceps1000 of FIG. 1A, with the lever 1024 in a force limiting state (e.g.,jaws stuck open, an over-travel position), in accordance with at leastone example. While FIGS. 13A, 13B and 13C show the lever 1024 in variouspositions of actuation, in all of FIGS. 13A, 13B and 13C, the trigger1034 is in an unactuated position. FIGS. 13A, 13B, 13C illustrateclose-up views of a portion of the handpiece 1001 shown and describedwith respect to FIGS. 4A, 4B and 4C. The outer hub 1060, the lever 1024and the trigger 1034 are shown in phantom so that some hidden portionswithin the handpiece 1001 are visible.

FIG. 13A shows the lever 1024 and the trigger 1034 in their unactuatedpositions. As shown in FIG. 13B, moving the lever 1024 in a proximaldirection (by force F1) actuates a linkage, which in this example is afour-bar type mechanism that can indirectly cause the drive shaft 1026to be retracted. The four links can include a first link L1 (e.g., aground link), a second link L2, a third link L3 and a fourth link L4.The first link L1 can be the housing 1014 which provides the groundingfor the linkage. The second link L2 can be provided by a portion of thelever 1024. The third link L3 can be the coupling link 1042 that isconnected between the second link L2 and the fourth link L4, and thefourth link L4 can be the drive link 1046. Note that while the groundlink L1 is provided by the housing 1014, the ground link L1 could alsobe a frame, or a separate link fixed to the housing 1014 or frame.

The second link L2 (e.g., lever 1024) can be pivotably coupled to theground link L1 (e.g., first link, housing 1014, frame). A first movableelement such as the drive body 1052 can be operatively coupled to thesecond link L2 (e.g., lever 1024) by a linkage including the third linkL3 (e.g., coupling link 1042) and the fourth link L4 (e.g., drive link1046). Actuating the second link L2 (e.g., lever 1024, a movable handleor another actuator) provides input to the linkage (L1, L2, L3, L4) tocause the drive body 1052 to move with respect to the ground link L1(e.g., housing 1014).

In other words, moving the lever 1024 in a proximal direction can causethe drive link 1046 of the four-bar mechanism to pivot about drive linkpivot axis A2, or another articulation mechanism, to provide an input tothe drive body 1052 to retract the drive shaft 1026. In the exampleforceps 1000, this action closes the jaws 1012 as shown in FIG. 13B. Insome examples, retraction of the drive shaft 1026 can cause a differenteffect besides closing jaws 1012 when used with a different endeffector. In some examples there may be fewer or more than four links inthe mechanism, such as a five bar, six bar or more than six barmechanism. Applying the linkage (L1, L2, L3, L4) to the non-limitingexample of FIGS. 13A, 13B and 13C, the lever 1024 is pivotably coupledto the housing 1014, and the drive link 1046 is pivotably coupled to thehousing 1014.

Described yet another way, and as labeled in FIG. FIG. 13B, moving theactuatable end of the lever 1024 proximally causes the lever 1024 torotate with respect to the housing 1014 about first pin 1038, whichcauses the first portion 1042B of coupling link 1042 to move proximally.By this motion, the second portion 1042C of coupling link 1042 is alsomoved proximally. The drive link 1046 is thereby caused to pivot withrespect to the housing 1014 such that the portion of the drive link 1046that is coupled to the coupling link 1042 at third pin 1048 and theportion of the drive link 1046 that engages the drive body 1052 at thedistal face 1088B (FIG. 13B), move proximally. Consequently, when thelever 1024 is reversed and allowed to move distally, all these actionsare reversed by the lever return spring 1040 which, in some cases, canalso result in causing the drive link 1046 to engage the drive body 1052at the proximal face 1089A (FIG. 13B).

In a situation where the lever 1024 is pulled proximally and the jaws1012 encounter some resistance, the drive shaft is placed under atensile load. This can occur if there is an impediment between the jaws1012, such as if there is tissue or another medical device locatedbetween the jaws 1012, or if the jaws 1012 are fully closed and thelever 1024 continues to be actuated. In this tensile state, there can bea tensile load in the drive link 1046 and also a tensile load in thecoupling link 1042. A benefit of such a tensile state is that relativelythin components can be used in a mechanism and such thin components aremore stable under tension than under compression, which can result inthe lever 1024 operating more smoothly than in a device that relies oncreating a compressive state in the components.

As shown in the inset of FIG. 13A, the coupling link 1042 can have amain body 1042A extending from a first portion 1042B pivotably coupledto the lever 1024, to a second portion 1042C pivotably coupled to thedrive link 1046. The coupling link 1042 can include a tab 1043 (ormultiple tabs) extending away from the main body 1042A. The couplinglink 1042 can reside within the lever recess 1025 in the lever 1024 (seecross-sectional view of lever 1024 in FIG. 3B).

The tab 1043 can provide one or more functions, including serving as ablocking tab to prevent the trigger 1034 from being prematurely orinadvertently actuated until the lever 1024 is at least partiallyactuated. The tab 1043 can include one or more blocking tab portions.The tab 1043 can extend away from a mid-portion of the main body 1042Alocated between the first portion and the second portion. The tab 1043can include first blocking tab portion 1043A extending away from themain body 1042A at an acute angle α relative to an axis A4 of the mainbody in a direction towards the trigger 1034. The first blocking tabportion 1043A can include a shelf that extends in a proximal-distaldirection to receive the trigger 1034.

The trigger 1034 can be operatively coupled to the housing 1014, such asby a pivotable coupling 1041. The trigger 1034 can serve as a secondlever or second actuator for actuating functions of the end effector1002. The trigger 1034 can be operatively coupled to a second movableelement, such as, but not limited to the spool 1064 (e.g., a secondmotion transfer body or cut block). When actuated, the trigger 1034 cancause the spool 1064 to move with respect to the housing 1014. Thetrigger 1034 can include a blocking surface 1035 having one or moreblocking surface portions, an example of which is labeled in FIG. 13B.

As illustrated in FIG. 13A, the tab 1043 on the coupling link 1042 canbe positioned to engage with at least a portion of the blocking surface1035 of the trigger 1034 to limit movement of the trigger 1034 until thelever 1024 is at least partially actuated. In an example where thetrigger 1034 extends a blade shaft 1032 to operate a cutting operationof the blade 1032A (FIG. 2 ), this prevents actuation of the blade 1032Auntil the jaws 1012 are at least partially closed or closed.

As illustrated in FIG. 13B, when the lever 1024 is at least partiallyactuated, the tab 1043 can move such that a clearance is created betweenthe tab 1043 and the blocking surface 1035, allowing the trigger 1034 tobe at least partially actuated. The blocking surface 1035 can includemultiple blocking surfaces such as a first blocking surface portion1035A and a second blocking surface portion 1035B.

In the illustrative example, as shown in the combination of FIGS. 13Aand 13B, and starting in the unactuated position of FIG. 13A, the firstblocking tab portion 1043A can engage the first blocking surface portion1035A and/or the second blocking tab portion 1043B can engage the secondblocking surface portion 1035B.

In the transition between the blocked position of FIG. 13A (e.g.,engaged position, unactuated lever 1024) and the unblocked position ofFIG. 13B (e.g., disengaged position, actuated position of the lever1024), different portions of the tab 1043 can engage and supportdifferent portions of the blocking surface 1035 throughout thekinematics of the linkage L1, L2, L3, L4. This is because as thecoupling link 1042 orientation changes with respect to the lever 1024and the drive link 1046, the orientation of the tab 1043 with respect tothe trigger 1034 can also change. The kinematics can affect whichportion(s) of the tab 1043 are engaging and supporting which portion(s)of the blocking surface 1035.

For example, as the lever 1024 is pulled and the tab 1043 transitionsfrom the blocked position in FIG. 13A to the unblocked position in FIG.13B, the first blocking tab portion 1043A may provide less engagementwith the first blocking surface portion 1035A, while the second blockingtab portion 1043B can play a larger role in inhibiting or limiting theactuation of the trigger 1034. In some examples, prior to disengagement,the second blocking tab portion 1043B can move and engage the firstblocking surface portion 1035A or a third blocking surface portion1035C, before completely disengaging from the trigger 1034, allowing thetrigger 1034 to be actuated, or at least partially actuated.

FIGS. 13B and 13C show two different unblocked positions, with FIG. 13Bshowing the lever 1024 in an actuated position, and FIG. 13C showing thelever 1024 in a second actuated position where the force F1 beingapplied to the lever 1024 is high enough that the force limiting aspectsof the motion transfer assembly 1051 are actuated. As shown in FIG. 13B,as the lever 1024 is moved through its range of motion by force F1applied by a user, the tab 1043 moves out of the way of trigger 1034such that the tab 1043 does not engage the blocking surface 1035further, and the trigger 1034 can be actuated. In the unblockedposition, the first blocking tab portion 1043A may not engage the firstblocking surface portion 1035A, the second blocking surface portion1035B or the third blocking surface portion 1035C; and the secondblocking tab portion 1043B may not engage any of the first blockingsurface portion 1035A, the second blocking surface portion 1035B, or thethird blocking surface portion 1035C.

The example forceps 1000 presents merely one example of actuation systemcomponents coupled to a housing 1014. In various examples, thecomponents may be located within or outside of the housing 1014. Forexample, at least a portion of the second link L2 (e.g., lever 1024) canbe located within or outside the housing 1014. At least a portion of thefourth link L4 (e.g. drive link 1046) can be located within or outsidethe housing 1014. At least a portion of the trigger 1034 can be locatedwithin or outside the housing 1014. At least a portion of the third linkL3 (e.g., coupling link 1042 can be located within or outside thehousing 1014. In some examples, at least a portion of the third link L3(e.g., coupling link 1042) can be external of the housing 1014 for afull range of travel of the third link L3.

FIG. 14A illustrates a side view of an example drive link 1046 of theforceps of FIG. 1A, in accordance with at least one example. FIG. 14Billustrates a proximal isometric view of the drive link 1046 of theforceps of FIG. 1A, in accordance with at least one example. FIG. 14Cillustrates a distal isometric view of the drive link 1046 of theforceps of FIG. 1A, in accordance with at least one example.

FIGS. 14A, 14B and 14C illustrate example surfaces of the drive link1046 and will be described together. As previously described withrespect to FIGS. 4A, 4B, 4C, 13A, 13B and 13C, the drive link 1046 isoperably coupled to the housing 1014. The drive link 1046 can beconfigured to transfer an input force F1 received from an actuator, suchas the lever 1024, into a linear motion of the drive body 1052 and thedrive shaft 1026. The drive link 1046 can transfer force to the drivebody 1052 via one or more cam surfaces of the drive link 1046. Asillustrated in the combination of FIGS. 14A, 14B and 14C, the drive link1046 can include one or more proximal cam surface(s) 1045A, 1045B formedon a proximal side of the drive link 1046 and one or more distal camsurface(s) 1047A, 1047B formed on a distal side of the drive link 1046.The proximal cam surfaces 1045A and 1045B can be arranged opposite thedistal cam surfaces 1047A, 1047B in the longitudinal direction of theforceps 1000 such that the proximal surface 1045A faces away from thedistal cam surface 1047A and such that the proximal cam surface 1045 Bfaces away from the distal cam surface 1047B. To drive the drive body1052 (FIG. 5A) in a proximal direction (e.g., to retract the drive shaft1026 and close the jaws 1012), the proximal cam surfaces 1045A, 1045Bcan be configured to interface with the collar 1088 shown in FIG. 5A. Todrive the drive body 1052 (FIG. 5A) in a distal direction (e.g., toextend the drive shaft 1026 and open the jaws 1012), the distal camsurfaces 1047A, 1047B can be configured to interface with a distalsurface or collar 1089 shown in FIG. 5A.

To improve the user's ergonomic experience and maximize space efficiencyin the handpiece 1001 and to minimize the overall length of the forceps1000, particularly in a longitudinal direction (L1, FIG. 1B), the camsurfaces 1045A, 1045B, 1047A and 1047B can be formed as portions ofconcentric cylinders. For example, in FIG. 14A, the portions ofconcentric cylinders 1049 is shown as being portions of cylinders ofequal diameter (e.g., as in D1), however, this is not required. Theproximal cam surfaces 1045A, 1045B can be of a different diameter thanthe distal cam surfaces 1047A, 1047B, but still remain concentric withone another about a common axis A3. For example, at least one of theproximal cam surfaces 1045A, 1045B can be formed as at least a portionof a first cylindrical surface 1049A having a diameter D1, while atleast one of the distal cam surfaces 1047A, 1047B can be formed as atleast a portion of a second cylindrical surface 1049B having a diameterD2, such that the at least a portion of the first cylindrical surface1049A and such that at least a portion of the second cylindrical surface1049B are concentric about a common axis A3.

In some examples, during the range of motion of the drive link 1046, thecommon axis A3 of the proximal cam surfaces 1045A, 1045B and the distalcam surfaces 1047A, 1047B is configured to pass below the drive linkpivot axis A2. In some examples, the common axis A3 is configured topass through a plane perpendicular to a translation axis A4 of the drivebody 1052 and which passes through the drive link pivot axis A2. In someexamples, during the range of motion of the drive link 1046, the commonaxis A3 is configured to pass through an axis of translation A4 of thedrive body 1052 twice. The axis of translation A4 can be an axiscoincident or parallel to the longitudinal axis A1 shown in FIG. 1B.

In some examples, because the proximal and distal cam surfaces 1045A,1045B, 1047A, 1047B can be formed by portions of cylindrical surfaces(e.g., 1049A and/or 1049B), the surface of the drive body 1052 thatdrives the cam surfaces 1045A, 1045B, 1047A, 1047B is arranged at aposition tangent to the relevant cam surface throughout the range oftravel. For example, as illustrated in the combination of FIGS. 5A and14A, because the proximal cam surfaces 1045A, 1045B include a circularshape, a distal face 1088B of the proximal collar 1088 can contact theproximal cam surfaces 1045A, 1045B at a position tangent to the proximalcam surfaces 1045A, 1045B over a range of motion of the drive link 1046.The range of movement of the drive link 1046 can correspond to the jaws1012 being displaced from an open position to a closed position (jaw1012 positions shown in FIGS. 1A and 1B). One benefit of thisarrangement is that the distance from the proximal cam surface 1045A tothe distal cam surface 1047A remains the same throughout rotation of thedrive link 1046. Because of this constant distance between the proximalcam surface 1045A and the distal cam surface 1047B (and likewise betweencam surfaces 1047A and 1047B), the distance between the distal face1088B of the proximal collar 1088 and the proximal face 1089A of thedistal collar 1089 can be reduced to a set distance. This is more spaceefficient compared to conventional forceps and provides a smooth motion.

While the cam surfaces 1045A, 1045B, 1047A, 1047B are shown anddescribed with reference to a drive link 1046 having a yoke and twoproximal cam surfaces 1045A, 1045B and two distal cam surfaces 1047A,1047B, any number of cam surfaces may be provided. In some examples, adrive link 1046 can include two or more cam surfaces without necessarilybeing yoke shaped. For example, a drive link can have only one leg andmay include a single proximal cam surface 1045A and a single distal camsurface 1047A. In other examples, a drive link can have an uneven numberof cam surfaces, such as a single proximal cam surface 1045A and twodistal cam surfaces 1047A, 1047B, or vice-versa. In some examples, therecan be any combination of two or more cam surfaces (e.g., 1045A, 1045B,1047A, 1047B) such that at least two opposing cam surfaces each includea portion of a cylindrical surface, and that the portions of thecylindrical surfaces are concentric about the common axis A3.

In some examples, the drive link 1046 can include one or more camsurfaces. In such an example, the drive body 1052 can include a face(e.g., distal face 1088B of collar 1088, FIG. 5A) to receive the drivesurface (e.g., cam surface 1045A) of the drive link 1046. In such anexample, the drive surface can include a portion of a cylinder having anaxis (e.g., A3) that is configured to pass below the drive link pivotaxis A2 when the drive link 1046 passes through its range of motionand/or pass through a longitudinal axis A1 of the translation of thedrive body 1052 when the drive link 1046 passes through its range oftravel. One benefit of such kinematics is that the distance the proximalcollar 1088 or distal collar 1089 has to be driven for the lowest amountof lever force F1 is optimized.

The common axis A3 can be perpendicular to a plane through thelongitudinal axis A1 (FIG. 1B) along which the drive body 1052translates and which intersects the drive link 1046. The common axis A2can be parallel to the drive link pivot axis A2 of the drive link 1046to the housing 1014.

FIG. 15A illustrates a cross-sectional view of a portion of the forceps1000 of FIG. 1A with the lever 1024 in an actuated position and thetrigger 1034 in an unactuated position, in accordance with at least oneexample. FIG. 15A is similar to FIG. 13C, illustrating a position wherethe clamping function is actuated by the lever 1024 such that the jaws1012 are closed by the action of the first motion transfer assembly 1051causing retraction of the drive body 1052 and the drive shaft 1026, butthe blade 1032A is not yet actuated.

FIG. 15B illustrates a cross-sectional view of the portion of theforceps 1000 of FIG. 1A with the lever 1024 in an actuated position andthe trigger 1034 in an actuated position (e.g., blade 1032A extended),in accordance with at least one example. In some examples, the trigger1034 does not have to be a trigger specifically, it can be a secondlever or another type of second actuator.

As shown in FIG. 15A, the trigger return spring 1068 biases the trigger1034 to a first position (e.g., default position, unactuated position,retracted position) such that the blade shaft 1032 remains in aretracted state until the trigger 1034 is compressed and movedproximally to actuate the blade 1032A (FIG. 2 ). In the first,unactuated position, the spool 1064 is in a proximal position on thedrive shaft 1026. The cross pin 1066 is in a proximal position withinfirst horizontal slot 1069A and second horizontal slot 1069B. As such,the trigger return spring 1068 is in a relaxed state floating betweenthe drive body 1052 and the spool 1064, or the second distal spring seat1091 and the proximal trigger return spring seat 1101. The blade shaft1032 is in a proximal position such that blade shaft 1032 is retracted.

To facilitate extension and retraction of the blade shaft 1032 and blade1032A (FIG. 2 ), the cross pin 1066 can move within one or moreaperture(s) (e.g., elongate aperture) in the drive shaft 1026, such asthe first horizontal slot 1069A and the second horizontal slot 1069B(hidden). The first and second horizontal slots 1069A and 1069B can actas guide rails for the longitudinal reciprocation of the spool 1064. Assuch, the spool 1064 can be guided along and by the drive shaft 1026.The first horizontal slot 1069A can extend into a first side of thedrive shaft 1026, and the second horizontal slot 1069B can extend into asecond side of the drive shaft 1026 across from or opposing the firsthorizontal slot 1069A. The first horizontal slot 1069A and the secondhorizontal slot 1069B can be in a proximal portion of the drive shaft1026 or near a proximal end of the drive shaft 1026 and can extend alongthe longitudinal axis A1 (FIG. 1B) of the drive shaft 1026. As such, thecross pin 1066 can extend from a first arm 1034C of the trigger 1034 toa second arm 1034D (hidden) of the trigger 1034 through the spool 1064,the first horizontal slot 1069A of the drive shaft 1026, the blade shaft1032, and the second horizontal slot 1069B of the drive shaft 1026. Thespool 1064 can include a proximal trigger return spring seat 1101 at adistal end of the spool 1064. As such, the trigger return spring 1068can be positioned on the drive shaft 1026 between a proximal end of thedrive body 1052, or the second distal spring seat 1091, and a distal endof the spool 1064, or proximal trigger return spring seat 1101.

As shown in FIG. 15B, to extend the blade 1032A, a user can apply anactuation force input F2 to the trigger 1034. The trigger 1034 can beconfigured to receive the force input F2 from a user and transfer theforce input to the spool 1064 via at least one arm 1034C of the trigger1034. When the trigger 1034 is compressed (and a distal portion of thetrigger 1034 is moved proximally) to a second, actuated position, thetrigger 1034 moves the spool 1064 distally with respect to the housing1014 and the cross pin 1066 translates distally within the firsthorizontal slot 1069A and the second horizontal slot 1069B. The spool1064, such as the proximal trigger return spring seat 1101 of the spool1064, can push the trigger return spring 1068 against the second distalspring seat 1091 until the preload of the trigger return spring 1068 isovercome and the trigger return spring 1068 compresses, allowing thespool 1064 to continue moving distally. The cross pin 1066 can beconstrained to the blade shaft 1032, such as by extending through a bore1032B (FIG. 2 ) in the blade shaft 1032, thereby constraining the crosspin 1066 to the blade shaft 1032. As a result, the blade shaft 1032 canmove distally into an extended position such that the blade 1032A (FIG.2 ) can be visible at a distal end of forceps 1000 or can be extendeddistally between the closed jaws 1012 and is not necessarily visible.When the trigger 1034 is released from the second position, the triggerreturn spring 1068 can expand, pushing against the proximal triggerreturn spring seat 1101 and driving the spool 1064 proximally withrespect to the housing 1014. As such, the cross pin 1066 can moveproximally within the first horizontal slot 1069A and the secondhorizontal slot 1069B, moving the blade shaft 1032 proximally to aretracted position such that the blade 1032A (FIG. 2 ) is no longervisible at a distal end of the forceps 1000. Without a force on thetrigger 1034, the trigger 1034 returns to the first position (FIG. 15A).

The proximal portion 1034A of the trigger 1034 can include the one ormore arms 1034C, 1034D (more visible in FIG. 17D). In the example, thefirst arm 1034C can be laterally spaced apart from the second arm 1034Dforming a yoke that receives the spool 1064 while the spool 1064 isconnected to the drive shaft 1026 by cross pin 1066 extendingtherethrough. Thus, because of the spool's 1064 cylindrical shape, andbecause the spool 1064 is not fixedly coupled to the arms 1034C, 1034D,the spool 1064 can rotate relative to the arms 1034C, 1034D of thetrigger 1034 to allow the drive shaft 1026 to rotate. In other words,the spool 1064 is rotatable with the drive shaft 1026 and is notinhibited by the arms 1034C, 1034D of the trigger 1034. This trigger1034 to spool 1064 interface can be described as a yoke-and-spool camconnection (similar to the drive link 1046 to drive body 1052connection). The yoke-and-spool cam connections allows the drive shaft1026 and the blade shaft 1032 within to rotate while still allowing thetrigger 1034 to engage the spool 1064 to impart movement of the spool1064 along the longitudinal axis A1 (FIG. 1B).

The spool 1064 provides a beneficial shape that allows the trigger 1034to extend the blade shaft 1032 while still permitting the drive shaft1026, which extends through the spool 1064 to rotate under an input ofthe rotational actuator 1030. As illustrated in the combination of theretracted position of the blade 1032A in FIG. 15A and the extendedposition of the blade 1032A in FIG. 15B, a body, such as but not limitedto the illustrative spool 1064, can be configured to be guided by thedrive shaft 1026 to displace the blade shaft 1032, and thereby the blade1032A, between the retracted position and the extended position.

It is not required that the spool 1064 be provided as an axisymmetricspool or as having a cylindrical body that allows for rotation of thespool 1064 relative to the trigger 1034. The spool 1064 canalternatively include a non-cylindrical body such as a cuboid orirregular shape, such as in examples that do not include a rotatabledrive shaft. For example, as when a drive shaft can be rotatably fixedwith respect to a housing to translate with respect to the housing. Insome examples, the spool 1064 can be described as a body, a second body,a second motion transfer body, a cut body, or a second drive body.

As illustrated in FIGS. 15A and 15B, the drive shaft 1026 can extendfrom a location proximal of the drive body 1052, through the spool 1064and towards a proximal end of the housing 1014. A benefit of the driveshaft 1026 extending through a second passageway 1064A (FIG. 2 ) in thespool 1064, and proximally past the spool 1064 to a proximal end of thehousing 1014 where it is supported by the stabilizing flange 1021, isthat the drive shaft 1026, in addition to providing actuation functionsto the jaws 1012, can also serve as a guide or rail for the spool 1064to ride along. In some examples, the drive shaft 1026 may extend throughthe stabilizing flange 1021.

With the spool 1064 located on or around the drive shaft 1026, the spoolcan move longitudinally along the drive shaft 1026, and although anaxisymmetric spool 1064 is shown, other examples of a second motiontransfer body can be provided that are not specifically a spool. In somesuch examples, such a second motion transfer body can be guided by thedrive shaft 1026, but the second motion transfer body does notnecessarily need to surround the drive shaft 1026 and may notspool-shaped or rotatable. The spool 1064 is shown as one example of amotion transfer body designed to transmit motion received from anactuator to a shaft (e.g., received from trigger 1034 and transmitted toblade shaft 1032). In other examples, a motion transfer body of thisdisclosure need not be spool-shaped, such as in examples where the spool1064 does not need to be rotatable.

The trigger return spring 1068 can be a helical compression springpositioned on the drive shaft 1026 between a distal end of spool 1064and a proximal end of drive body 1052. Conventional trigger returnsprings have disadvantages in that they are generally backed up againsta fixed flange on a housing. The illustrative trigger return spring 1068being a floating spring that is positioned between the spool 1064 andthe drive body 1052 has advantages in that there is no need to design ina flange in the housing 1014 that has to interface with the triggerreturn spring 1068. The axial stack-up along the direction of thelongitudinal axis A1 (FIG. 1B) of the forceps can be reduced, shorteningthe length of the forceps 1000, improving ergonomics. In addition, thetrigger return spring 1068 can be easily assembled by loading it ontothe drive shaft 1026, hence, in contrast to conventional forceps, thereis no additional assembly step of securing a spring end to a flange in ahousing.

FIG. 16A is cross-sectional view of a portion of the forceps 1000 alongline 16A-16A′ in FIG. 15A with the trigger 1034 in the unactuatedposition of FIG. 15A, in accordance with at least one example. FIG. 16Bis a cross-sectional view of the portion of the forceps 1000 along line16B-16B′ in FIG. 15A with the trigger 1034 in the actuated position ofFIG. 15B, in accordance with at least one example. FIGS. 16A and 16Bwill be described together.

As shown in FIG. 16A, the spool 1064 can extend from a proximal endportion to a distal end portion and can include one or more peripheralflanges (e.g., 1067A, 1067B) extending outward from a minor diameter D3towards the housing 1014. In the example, the spool 1064 includes aproximal flange 1067A, a distal flange 1067B and the minor diameter D3extending therebetween along the longitudinal axis A1.

When a distal portion 1034B of the trigger 1034 is moved proximally, thearms 1034C, 1034D of the trigger 1034 slide along the minor diameter D3of the spool 1064 until the arms 1034C, 1034D come into contact with thedistal flange 1067B of the spool 1064. Once the arms 1034C, 1034D are incontact with the distal flange 1067B, the arms 1034C, 1034D can pushagainst the distal flange 1067B of the spool 1064. As the distal portion1034B of the trigger 1034 continues to be actuated proximally, the arms1034C, 1034D, pushing against the distal flange 1067B cause the spool1064 to slide distally along the drive shaft 1026 relative to thehousing 1014, thereby extending the blade assembly including the bladeshaft 1032 relative to the housing 1014.

When a user is finished actuating the blade 1032A and releases theactuation force input F2 on the trigger 1034, the distal portion of thetrigger 1034 can be moved distally by the force of the compressedtrigger return spring 1068 unloading. As the arms 1034C, 1034D of thetrigger 1034 slide along the minor diameter D3 of the spool 1064 thearms 1034C, 1034D can eventually come into contact with the proximalflange 1067A of the spool 1064. Once the arms 1034C, 1034D are incontact with the proximal flange 1067A, the arms 1034C, 1034D can push,by the force of the compressed trigger return spring 1068, against theproximal flange 1067A of the spool 1064 to return the spool 1064, bysliding proximally along the drive shaft 1026 to the default proximalposition of FIG. 15A, thereby retracting the blade shaft 1032 relativeto the housing 1014.

With continued reference to FIGS. 16A and 16B, one or both of theproximal flange 1067A and the distal flange 1067B can be taperedflanges, such as dual-acting tapered flanges. This allows for betterangles between the components in the handpiece 1001, improved kinematicsand ease of use. However, it is possible that if an excessive force isapplied by a user to move the trigger 1034 proximally, the arms 1034C,1034D of the trigger 1034 can be caused to splay, deflect or bendoutward laterally away from the longitudinal axis A1 and cause the arms1034C, 1034D of the trigger 1034 to disengage from the spool 1064. Inother words, the magnitude of the actuation input force F2 (FIG. 16B) issuch that it causes at least one of the arms 1034C, 1034D to be deformedoutward laterally in the direction L or L′.

To manage the splay of one or more of the arms 1034C, 1034D, the housing1014 can include one or more control surfaces 1013C, 1015D configured toprevent splaying of the one or more arms. Splay is most likely to occurwhen the arms 1034C, 1034D apply a force to the distal flange 1067B atthe distal end of travel of the arms 1034C, 1034D. Splay may also occur,though less likely, when the arms 1034C, 1034D apply a force to theproximal flange 1067A at the proximal end of travel of the arms 1034C,1034D. For example, a first control surface 1013C can extend towards afirst arm 1034C such that lateral splay of the first arm 1034C iscontrolled by the first control surface 1013C. Likewise, a secondcontrol surface 1015D can extend towards a second arm 1034D such thatlateral splay of the second arm 1034D is controlled by the secondcontrol surface 1015D.

In some examples, the control surfaces 1013C, 1015D can be coupled to orintegrally formed in the first housing portion 1016 or the secondhousing portion 1018. As shown in the example of FIGS. 16A, 16B, the oneor more control surfaces 1013C, 1015D can be provided as rib(s) 1017C,1017D formed on the inside of the first housing portion 1016 and thesecond housing portion 1018 that extend inward towards the arms 1034C,1034D. The first rib 1017C can be arranged opposite or facing the secondrib 1017D. The first rib 1017C can extend inward from a first innersurface 1016A of the first housing portion 1016 and along aproximal-distal direction. The second rib 1017D can extend inward from asecond inner surface 1018A of the second housing portion 1018 and alonga proximal-distal direction. With the arms 1034C, 1034D that form theyoke located about the spool 1064, the arms 1034C, 1034D can beconstrained between the first rib 1017C and the second rib 1017D. Inthis arrangement, if one of the arms 1034C, 1034D pushing against one ofthe ribs 1017C, 1017D tries to splay outward, the arm 1034C or 1034Dwill be restrained by the rib 1017C or 1017D and kept inward such thatthe arm 1034C or 1034D maintains contact with the spool 1064 to transmitforce from the yoke of trigger 1034 to the spool 1064. In some examples,the trigger 1034 may include only one arm and the housing only one ribor other control surface.

In other examples, the control surfaces 1013C, 1015D that prevent (e.g.,inhibit, limit, constrain) splaying of the arms 1034C, 1034D may not beprovided as ribs 1017C, 1017D, but rather can include an inner surface1016A, 1018A of the housing 1014 formed in a particular shape, arrangedin a manner, or positioned relative to at least one arm 1034C, 1034D torestrict lateral splaying of the arm 1034C, 1034D, thereby preventingdisengagement of the arm 1034C, 1034D from the proximal or distalflanges 1067A, 1067B of the spool 1064. In some examples, the respectivearm 1034C, 1034D and control surface 1013C, 1015D can be in contact withone another along at least a portion of a full range of travel of thearm 1034C, 1034D. For example, the travel of the arms 1034C, 1034Dbetween the unactuated position of FIG. 16A and the actuated position of16B.

To manage lateral splaying of the arms 1034C, 1034D, a gap 1019C, 1019Dor no gap can be provided between the first arm 1034C and the firstcontrol surface 1013C, and between the second arm 1034D and the secondcontrol surface 1015D. For example, as shown in FIG. 16A, the gap 1019Ccan be located between the first control surface 1013C and the first arm1034C along at least a portion of the first control surface 1013C. Toprevent the first arm 1034C from splaying outward when the trigger 1034is actuated to the degree that the first arm 1034C disengages from thedistal flange 1067B, the first gap 1019C can have a distance that isless than an arm thickness 1034E of the first arm 1034C. In someexamples, a second gap 1019D can have a distance that is less than asecond arm thickness 1034F of the second arm 1034D.

In some examples, the arm thickness 1034E or 1034F can be in a rangebetween about 0.5 mm-4 mm, and the respective gap 1019C or 1019Ddistance can be in a range between about 10-90% of the arm thickness1034E or 1034F. In another example, the arm thickness 1034E or 1034F canbe in a range between about 0.5-3.0 mm and the respective gap 1019C or1019D can be 10-60% of the arm thickness 1034E or 1034F. In a possiblymore preferred example, the arm thickness 1034E or 1034F can be in arange between about 1-2 mm, and the respective gap 1019C or 1019Ddistance can be in a range between about 10-50% of the arm thickness1034E or 1034F. In a possibly yet more preferred example, the armthickness 1034E or 1034F can be in a range between 1.4 mm and 1.7 mm,and the gap 1019C or 1019D distance can be in a range between 0.1 mm and0.75 mm.

The arrangement of the arm thickness 1034E or 1034F compared to therespective gap 1019C or 1019D distance can also be defined by a ratio ofthe gap 1019C or 1019D distance compared to the respective arm thickness1034E or 1034F (e.g. gap-arm ratio). For example, the gap-arm ratio maybe between 1/10 and 9/10 (e.g., the gap is 10-90% of the arm thickness).However, depending on the device specifics, in possibly more preferredexample, the gap-arm ratio may be about 30% plus or minus 25%, or thegap-arm ratio may be in a range between about 1/5 and 3/5 (e.g., the gapdistance is 20% to 600% of the arm thickness). In some possiblypreferred examples, to prevent the arms 1034C and 1034D from splaying,the ratio may be less than 1/2, or in a range between 10% and 50%.

When the trigger 1034 is actuated, the first arm 1034C and the first rib1017C can be in contact with one another along at least a portion of arange of travel of the first arm 1034C. Likewise, the second arm 1034Dand the second rib 1017D can be in contact with one another along atleast a portion of a range of travel of the second arm 1034D.

FIG. 17A is a side view of a subassembly 1500 of the forceps 1000 ofFIG. 1A. The subassembly 1500 held in a hand during assembly, with somecomponents shown in phantom, in accordance with at least one example.FIG. 17B is a side view of the subassembly 1500 of FIG. 17A insertedinto the housing (e.g., second housing portion 1018) with somecomponents shown in phantom, in accordance with at least one example.FIG. 17C is a side view of the subassembly 1500 and the second housingportion 1018 of FIG. 17B shown in solid, in accordance with at least oneexample. FIG. 17D is a proximal isometric view of the subassembly 1500and the second housing portion 1018 of FIG. 17C, in accordance with atleast one example. FIGS. 17A, 17B, 17C and 17D will be describedtogether.

When assembling medical devices such as the forceps 1000, it can bedifficult to assemble a set of links onto multiple pivot attachments ina housing. The parts tend to move around making it hard to alignmultiple pivots with corresponding attachments in the housing. Toimprove the ease of assembly, the inventors have discovered that thenested subassembly 1500 can be aligned with and inserted into thehousing 1014.

The subassembly 1500 of FIG. 17A can be formed and held as a temporarysubassembly 1500 in an assembler's hand. For example, the subassembly1500 can be held together by the support of the user's hand along withthe nested arrangement of the lever 1024, the coupling link 1042 and thetrigger 1034. Assembly is improved because creating the subassembly 1500allows both a lever pivot 1027 on the lever 1024 and a trigger pivot1037 on the trigger 1034 to be aligned with and coupled to the pivotattachments on the second housing portion 1018 in one step (e.g., in oneaction at the same time).

As shown in the combination of FIGS. 17A-17D, a boss 1027A can extendaround at least a portion of the lever pivot 1027. The lever pivot 1027can interface with the housing 1014 to allow the lever 1024 to rotateabout a lever pivot axis P1 (FIG. 17C).

The trigger 1034 can include the arm 1034C having a recess 1039configured to receive the boss 1027A. The coupling link 1042 pivotablycoupled to the lever 1024 can include the main body 1042A and the tab1043 extending away from the main body 1042A. As shown and described inFIGS. 13A, 13B, 13C, the tab 1043 on the coupling link 1042 can bearranged to provide support to an inner surface (e.g., blocking surface1035 shown and described in FIGS. 13A, 13B, 13C) of the trigger 1034when the boss 1027A is seated in the recess 1039. The tab 1043 canextend away from the main body 1042A at an acute angle towards the innersurface (e.g., 1035) of the trigger 1034. In the illustrative example,the tab 1043 can extend away from a mid-portion of the main body 1042A.In other examples, the tab 1043 can extend away from any portion of themain body 1042A, including an end of the main body 1042A.

FIG. 18 illustrates a method 1800 of assembling a medical device, suchas the forceps 1000 including the subassembly 1500 of FIGS. 17A-17D. Inoperation 1802, the method 1800 can include in pivotably connecting thecoupling link 1042 to a first lever, such as the lever 1024. Thecoupling link 1042 can include the main body 1042A and the tab 1043extending away from the main body 1042A, and the lever 1024 can includethe lever pivot 1027 and the boss 1027A.

Operation 1804 can include nesting the lever 1024 and the coupling link1042 with a second lever, such as the trigger 1034 having trigger pivot1037. In the nested position, a recess 1039 in the trigger 1034 can besupported by the boss 1027A. In some examples, the nesting step inoperation 1804 can include inserting the coupling link 1042 and thelever 1024 in between the two spaced apart arms 1034C, 1034D of thetrigger 1034. Operation 1806 can include supporting the inner surface(e.g., 1035) of the trigger 1034 with the coupling link 1042 to providea subassembly 1500 held in a sub-assembled state.

With the subassembly 1500 held in a hand of an assembler, operation 1808can include pivotably coupling the lever pivot 1027 to the housing 1014(e.g., or a frame) and pivotably coupling the trigger pivot 1037 to thehousing 1014. Coupling the lever pivot 1027 and trigger pivot 1037 inoperation 1808 can be performed, for example, simultaneously,substantially simultaneously, or in a single motion or step. Pivotablycoupling the lever 1024 to the housing 1014 can include aligning thelever pivot 1027 and the boss 1027A with the lever pivot attachment1017A on the housing 1014. Pivotably coupling the trigger 1034 to thehousing 1014 can include aligning the trigger pivot 1037 with thetrigger pivot attachment 1017B on the housing 1014.

In some examples, the recess 1039 is supported by the boss 1027A and theinner surface (e.g., 1035) of the trigger 1034 is supported by the tab1043 such that the lever pivot 1027 can be connected to a lever pivotattachment 1017A of the housing 1014 and the trigger pivot 1037 can beconnected to the trigger pivot attachment 1017B of the housing 1014without dislodging the recess 1039 from the boss 1027A.

In the sub-assembled state, the lever pivot 1027 and the trigger pivot1037 can provide a like distance D2 to the distance between the leverpivot attachment 1017A and the trigger pivot attachment 1017B on thehousing 1014. The like distance can include, but is not limited to, thesame distance, the same distance within reasonable manufacturing andassembly tolerances, a distance that facilitates assembly of the lever1024 and the trigger 1034 to the housing 1014 in one step. In someexamples, the distance D2 can be measured between the lever pivot axisP1 and the trigger pivot axis P2 as assembled.

Although method 1800 is described with reference to the forceps 1000 ofFIG. 1A, the method 1800 can be performed to assemble other medicaldevices having a frame, a first lever having a first pivot, a secondlever having a second pivot (such as but not limited to, a trigger), acoupling link and first and second pivot attachments on the frame.

FIG. 19A illustrates a distal end of the forceps 1000 of FIG. 1Aincluding a wire harness 1900 routing, in accordance with at least oneexample. FIG. 19B illustrates a portion of the forceps 1000 of FIG. 1Aincluding the wire harness routing 1900 of FIG. 19A, in accordance withat least one example.

The wire harness 1900 can provide electromagnetic energy, for example,to actuate one or more electrodes of the end effector 1002 of FIG. 1A.The wire harness 1900 can enter housing 1014, for example, at the handleportion 1020A, 1020B. The wire harness 1900 can include one or more lowvoltage wires and one or more high voltage wires. For example, as shownin FIG. 21 , the wire harness 1900 can include a pair of low voltagewires 1902 and a pair of high voltage wires 1904 grouped together in apolymeric covering 1906.

As the plurality of high and low voltage wires travel into the housing1014, the wires can be separated into the pair of low voltage wires 1902and a pair of high voltage wires 1904. The pair of low voltage wires1902 can route to one or more switches 1914 via connector 1912 that canform part of a flexible printed circuit board. The one or more switches1914 can be, for example, dome switches that are actuatable by theactivation button 1036. The pair of high voltage wires 1904 can route toone or more electrical couplings 1908A, 1908B that are in electricalcommunication with the end effector 1002. In an example, the low voltagepair of wires 1902 can carry a 12-volt DC current to the activationbutton 1036 (FIG. 1A). The activation button 1036 can include or becoupled to the one or more switches, such as a two dome switches by theactivation button 1036 that floats above a flexible circuit board withthe switches. When the activation button 1036 is pushed, a post or hookon the activation button 1036 can depress the dome switches 1914 toclose the circuit.

The activation button 1036 can be a wraparound multi-directional button.The activation button 1036 can be pushed anywhere on the button and inany direction to activate the switch 1914. A feature on the activationbutton 1036, such as a post or hook formed on an inner surface facingthe switches 1914, along with the two dome switches 1914 laterallyspaced apart on sides of the handpiece 1001 make it possible to activatethe activation button 1036 from many directions. This arrangement makesit easy for a user to activate. In the example, the two switches 1914are arranged generally symmetrically about the longitudinal axis of theforceps 1000.

The low voltage pair of wires 1902 can include a ground wire and areference wire forming a closed circuit. In an example, the high voltagepair of wires 1904 can carry 2265-volt, 450,000 Hz, 505 amps of currenthaving waves that are out of phase with each other. The high voltagepair of wires 1904 can carry power to the end effector 1002.

The pair of high voltage wires 1904 can terminate at the electricalcoupling 1908 where they can be electrically coupled to a pair of wires1910 (hereinafter, “drive shaft wires”) that travel through the driveshaft 1026. The electrical coupling 1908 and drive shaft wires 1910facilitates adapting a single wire harness 1900 to accommodate forcepshaving drive shafts 1026 of different lengths. The pair of drive shaftwires 1910 can enter the proximal end of the of the drive shaft 1026 andcan travel through the drive shaft 1026 alongside the blade shaft 1032and exit out of the distal end of the drive shaft 1026. The pair ofdrive shaft wires 1910 can be coupled to the end effector 1002 at adistal end of the drive shaft 1026. In some examples the pair of highvoltage wires 1904 can provide power to one or more electrodes of thejaws 1012. The routing of the drive shaft wires 1910 proximate the endeffector 1002 is further discussed herein.

FIG. 20A illustrates an isometric view of a portion of a forceps 2000 ina closed position, in accordance with at least one example of thisdisclosure. FIG. 20B illustrates an isometric view of a portion of theforceps 2000 in a partially open position. FIG. 20C illustrates anisometric view of a portion of the forceps 2000 in an open position.FIGS. 20A-20C also show axis A1 and orientation indicators Proximal andDistal. FIGS. 20A-20C are discussed below concurrently.

The forceps 2000 can be surgical forceps consistent with the descriptionabove, such that the forceps 2000 can be operated to open and close jawsto grasp tissue, apply electrical energy to the tissue, and/or to cutthe tissue, such as may be employed during a surgery, biopsy ortreatment procedure. Any of the features of the forceps 2000 or anyforceps or end effectors discussed below can be included in the forcepsdiscussed above. Further details of the forceps 2000 are discussedbelow.

The forceps 2000 can include an upper jaw 2010, a lower jaw 2012, aguide (or proximal pin) 2014, a drive pin 2016, and a pivot pin 2018.The upper jaw 2010 can include flanges 2020 a and 2020 b (collectivelyreferred to as the flanges 2020) and an upper grip plate 2023; and, thelower jaw 2012 can include flanges 2022 a and 2022 b (collectivelyreferred to as the flanges 2022) and a lower grip plate 2024. (Theflanges 2020 and 2022 can also be referred to as struts herein.) Theforceps 2000 can also include an inner shaft 2026 (or inner tube ordrive shaft), an outer shaft 2028 (or outer tube), and a distal plug2030. The inner shaft 2026 can include inner arms 2034 a and 2034 b(collectively referred to as the inner arms 2034). The outer shaft 2028can include outer arms 2038 a and 2038 b (collectively referred to asthe outer arms 2038). The flanges 2020 a and 2020 b can include tracks2040 a and 2040 b, respectively (collectively referred to as tracks2040). The flanges 2022 a and 2022 b can include tracks 2042 a and 2042b, respectively (collectively referred to as tracks 2042). A portion ofthe forceps 2000 shown in FIGS. 20A-20C can be referred to as an endeffector 2002.

The components of the forceps 2000 can each be comprised of materialssuch as one or more of metals, plastics, foams, elastomers, ceramics,composites, combinations thereof, or the like. Materials of somecomponents of the forceps are discussed below in further detail.

The jaws 2010 and 2012 can be rigid members configured to engage tissue.The jaws 2010 and 2012 can be coupled to the outer shaft 2028, such aspivotably coupled, via the pivot pin 2018. The pivot pin 2018 can extendthrough a portion of the jaws 2010 and 2012 (such as a bore of each ofthe jaws 2010 and 2012) such that the pivot pin 2018 can be received bythe outer arms 2038 of the outer shaft 2028. In other examples, the jaws2010 and 2012 can be pivotably coupled to the outer shaft 2028 via aboss (or bosses) of the outer shaft 2028. In another example, the jaws2010 and 2012 can include a boss (or bosses) receivable in bores of theouter shaft 2028 to pivotably couple the jaws 2010 and 2012 to the outershaft 2028. In another example, outer shaft 2028 can include a boss (orbosses) receivable in bores of the jaws 2010 and 2012 to pivotablycouple the jaws 2010 and 2012 to the outer shaft 2028.

The flanges 2020 a and 2020 b (which can be a set of flanges, that is,two flanges) can be rigid or semi-rigid members located at a proximalportion of the jaw 2010. Similarly, the flanges 2022 a and 2022 b can berigid or semi-rigid members located at a proximal portion of the jaw2012. In some examples, the flanges 2020 can be positioned laterallyoutward of the inner flanges 2022. In other examples, the flanges 2020and 2022 can be interlaced.

The grip plates 2023 and 2024 of the jaws 2010 and 2012 can each be arigid or semi-rigid member configured to engage tissue and/or theopposing jaw to grasp tissue, such as during an electrosurgicalprocedure. One or more of the grip plates 2023 and 2024 can include oneor more of serrations, projections, ridges, or the like configured toincrease engagement pressure and friction between the grip plates 2023and 2024 and tissue. The flanges 2020 of the upper jaw 2010 can extendproximally away from the grip plate 2023 and 2034, and in some examples,substantially downward when the upper jaw 2010 is in the open andpartially open positions (as shown in FIGS. 20B and 20C, respectively).Similarly, the flanges 2022 of the lower jaw 2012 can extend proximallyaway from the grip plate, and in some examples, substantially upwardwhen the upper jaw 2010 is in the open and partially open positions (asshown in FIGS. 20B and 20C, respectively), such that the jaws 2010 and2012 and flanges 2020 and 2022 operate to open and close in a scissoringmanner. The jaws 2010 and 2012 can each include an electrode configuredto deliver electricity to tissue (optionally through the grip plates2023 and 2024), a frame supporting the electrode, and a blade slotconfigured to receive a blade between the jaws 2010 and 2012, asdiscussed in detail below.

The tracks 2040 of the flanges 2020 and the tracks 2042 of the flanges2022 can each be a track, channel, path, or slot in the flanges 2020 and2022, respectively. In some examples, the tracks 2040 and 2042 can belocated proximally of the pivot pin 2018 when the pivot pin 2018 iscoupled to the jaws 2010 and 2012 (and optionally to the outer shaft2028). The tracks 2040 and 2042 can be shaped to receive the drive pin2016 therein. In some examples, the tracks 2040 and 2042 can be slots orchannels configured to receive the drive pin 2016 therethrough toconnect the drive shaft 2026 (such as the inner arm 2034 a and/or theinner arm 2034 b) to the flanges 2020 and 2022 (and therefore to thejaws 2010 and 2012).

The tracks 2040 and 2042 can be straight in some examples and can bearcuately shaped in some examples. In any example, the tracks 2040 and2042 can be configured to allow the drive pin 2016 to travel along thetracks 2040 and 2042 simultaneously to open and close the jaws.

Each of the inner shaft 2026 and the outer shaft 2028 can be a rigid orsemi-rigid and elongate body having a geometric shape of a cylinder,where the shape of the inner shaft 2026 matches the shape of the outershaft 2028. In some examples, the inner shaft 2026 and the outer shaft2028 can have other shapes such as an oval prism, a rectangular prism, ahexagonal prism, an octagonal prism, or the like. In some examples, theinner shaft 2026 and the outer shaft 2028 can be shaped so that theinner shaft 2026 cannot rotate with respect to the outer shaft 2028, butthe inner shaft 2026 can still translate with respect to the outershaft. For example, the inner shaft 2026 and the outer shaft 2028 can beconcentric oval prisms. In another example, the inner shaft 2026 and theouter shaft 2028 can be rectangular tubes sized to limit relativerotation of the inner shaft 2026 with respect to the outer shaft 2028.In some examples, the shape of the inner shaft 2026 can be differentfrom the shape of the outer shaft 2028.

The inner shaft 2026 can extend substantially proximally to distallyalong the axis A1, which can be a longitudinal axis. Similarly, theouter shaft 2028 can extend substantially proximally to distally alongthe axis A1. In some examples, the axis A1 can be a central axis of oneor more of the inner shaft 2026 and the outer shaft 2028. The innershaft 2026 can include an axial bore extending along the axis A1. Theouter shaft 2028 can also include an axial bore extending along the axisA1. The inner shaft 2026 can have an outer dimension (such as an outerdiameter) smaller than an inner diameter of the outer shaft 2028 suchthat the inner shaft 2026 can be positioned within the outer shaft 2028and can be translatable therein along the axis A1. The inner shaft 2026can also be referred to as a drive shaft 2026, a cam shaft 2026, or aninner tube 2026. The outer shaft 2028 can also be referred to as anouter tube 2028.

The inner arms 2034 a and 2034 b (distal arms) of the inner shaft 2026can extend distally from a distal portion of the inner shaft 2026 andthe inner arms 2034 a and 2034 b can be positioned laterally outward ofthe flanges 2020 and 2022. In some examples, the inner arms 2034 a and2034 b can together form a fork or clevis. The outer arms 2038 a and2038 b can extend distally from a distal portion of the outer shaft 2028to form a fork or clevis. In some examples, the outer arms 2038 a and2038 b can extend distally beyond the inner arms 2034 a and 2034 b toreceive the pivot pin 2018 therein to secure the flanges 2020 and 2022(and therefore the jaws 2010 and 2012) to the outer shaft 2028.

The jaw 2010 can include the flanges 2020 a and 2020 b and the jaw 2012can include the flanges 2022 a and 2022 b. The jaws 2010 and 2012 caneach include two flanges to help distribute forces applied to the jawsby the drive pin 2016. For example, use of two flanges per jaw can helpto reduce forces applied to the tracks 2040 and 2042 by the drive pin2016 during opening and closing of the jaws 2010 and 2012. The use oftwo flanges per jaw can also help to stabilize operation of the jawsbecause the pin 2016 has multiple contact points on each jaw. That is,the drive pin 2016 contacts each of the flanges 2020 a and 2020 b andthe flanges 2022 a and 2022 b.

The distal plug 2030 can be a plug positionable within the outer shaft2028 between the outer arms 2038 such that the inner arms 2034 cantranslate around the distal plug. The distal plug 2030 can include ablade channel extending therethrough to allow the blade 2032 to extendthrough (and translate with respect to) the distal plug 2030. The distalplug 2030 can include one or more conduit bores for receiving conduit(connected to the electrodes of the jaws 2010 and 2012) therethrough.The distal plug 2030 is discussed in further detail below.

The blade 2032 can be an elongate cutting member including one or moresharpened edges configured to cut or resect tissue or other items. Theblade 2032 can be located within the outer shaft 2028 (and within theinner shaft 2026) and can extend along (and optionally parallel with)the axis A1. The blade 2032 can be translatable with respect to theinner shaft 2026 and the outer shaft 2028 to extend between (or into)the first jaw 2010 and the second jaw 2012. In some examples, the blade2032 can extend axially through the inner shaft 2026 and can belaterally offset from the axis A1. In some examples, the blade 2032 theblade can extend axially through the flanges 2020 and 2022 such that theblade 2032 is in a position laterally inward of the first set of flanges2020 and the second set of flanges 2022.

The guide 2014, the drive pin 2016, and the pivot pin 2018 can each be arigid or semi-rigid pin, such as a cylindrical pin. The guide 2014, thedrive pin 2016, and the pivot pin 2018 can have other shapes in otherexamples, such as rectangular, square, oval, or the like. In someexamples, each pin can be the same size (e.g., diameter and length) tosimplify manufacturing and reduce cost. Each pin can have a smoothsurface to help reduce surface friction between the pins and componentsof the forceps 2000, such as between the pivot pin 2018 and the outershaft 2028 or the drive pin 2016 and the flanges 2020 and 2022. In someexamples, each of the guide 2014, the drive pin 2016, and the pivot pin2018 can be other components such as one or more projections, bosses,arms, or the like.

Operation of the forceps 2000 is discussed below in the discussion ofFIG. 21 with reference to FIGS. 20A-20C.

FIG. 21 illustrates a side view of a portion of the forceps 2000 in anopen position, in accordance with at least one example of thisdisclosure. FIG. 21 also show the axis A1 and orientation indicatorsProximal and Distal. The forceps 2000 of FIG. 21 can be consistent withthe forceps discussed with respect to FIGS. 20A-20C; FIG. 21 shows theforceps 2000 with the outer shaft 2028 in phantom.

FIG. 21 also shows outer slots 2044 a and 2044 b (only slot 2044 b isvisible win FIG. 21 ). The outer slots 2044 a and 2044 b (collectivelyreferred to as the outer slots 2044) can be axial slots extendingthrough opposing portions of the outer shaft 2028. In some examples, theouter slot 2044 a can be on the arm 2038 a on an opposite side of theouter tube 2028 from the outer slot 2044 b on the arm 2038 b. The outerslots 2044 can be sized to receive the drive pin 2016 therein such thatthe drive pin 2016 can translate along the outer slots 2044 (when theinner shaft 2026 translates with respect to the outer shaft 2028) inexamples where the drive pin 2016 extends laterally outward from outersurfaces of the inner shaft 2026. In some examples, the outer slots 2044can be tracks extending into a portion of the outer shaft 2028 (and notentirely through the outer shaft 2028).

In operation of some examples, a handle (such as those discussed above)can be operated to translate the inner shaft 2026 within (and withrespect to) the outer shaft 2028. For example, distal translation of theinner shaft 2026 with respect to the outer shaft 2028 can cause thedrive pin 2016 to translate distally causing the jaws 2010 and 2012 tomove from a closed position (as shown in FIG. 20A) to an intermediateposition (as shown in FIG. 20B) to an open position (as shown in FIGS.20C and 431 ). Conversely, proximal translation of the inner shaft 2026can cause the drive pin 2016 to translate proximally to move the jaws2010 and 20112 to the closed position, such that the drive pin 2016 cantranslate to cause the jaws 2010 and 2012 to open and close in ascissoring manner. In other examples, the action can be reversed suchthat distal movement of the inner shaft 2026 can cause the jaws 2010 and2012 to move toward a closed position and proximal movement of the innershaft 2026 can cause the jaws 2010 and 2012 toward an open position.

More specifically, in one example, distal translation of the inner shaft2026 can cause the drive pin 2016 to translate distally within the outerslots 2044 such as to help guide axial translation of the drive pin 2016by helping to limit rotation of the inner shaft 2026 with respect to theouter shaft 2028 and by helping to limit non-axial movement of the innershaft 2026 with respect to the outer shaft 2028. As the drive pin 2016translates distally in the outer slots 2044, the drive pin 2016 cantranslate distally along (such as within) the tracks 2040 of the flanges2020 of the upper jaw 2010 and along the tracks 2042 of the flanges 2022of the lower jaw 2012. Because the tracks 2040 and 2042 can be angledand/or curved along the flanges 2020 and 2022, respectively, and becausethe tracks 2040 and 2042 can be oppositely oriented with respect to eachother, distal translation of the drive pin 2016 can cause the jaws 2010and 2012 to open in a scissor type movement. That is, the upper jaw 2010moves upward and its flanges 2020 move downward, and the lower jaw 2012moves downward and its flanges 2022 move upward, moving the upper jaw2010 and the lower jaw 2012 toward (and ultimately into) an openposition.

Distal translation of the inner shaft 2026 can be limited by contactbetween the drive pin 2016 and a distal end of each of the outer slots2044 (as shown in FIG. 21 ). In some examples, distal translation of theinner shaft 2026 can be limited by contact between the drive pin 2016and a distal end of each of the tracks 2040 and 2042. In other examples,distal translation of the inner shaft 2026 can be limited by contactbetween the guide 2014 and a portion of the inner shaft 2026.

To close the jaws, the inner shaft 2026 can be translated proximally toproximally translate the drive pin 2016, which causes the drive pin 2016to translate proximally within the outer slots 2044. As the drive pin2016 translates proximally in the outer slots 2044, the drive pin 2016can translate proximally along (such as within) the tracks 2040 of theflanges 2020 of the upper jaw 2010 and along the tracks 2042 of theflanges 2022 of the lower jaw 2012. Proximal translation of the drivepin 2016 can cause the jaws 2010 and 2012 to close in a scissor typemovement. That is, the upper jaw 2010 moves downward and its flanges2020 move upward, and the lower jaw 2012 moves upward and its flanges2022 move downward, moving the upper jaw 2010 and the lower jaw 2012toward (and ultimately into) a closed position.

Proximal translation of the inner shaft 2026 can be limited by contactbetween the drive pin 2016 and a proximal end of each of the outer slots2044. In some examples, proximal translation of the inner shaft 2026 canbe limited by contact between the drive pin 2016 and a proximal end ofeach of the tracks 2040 and 2042. In other examples, proximaltranslation of the inner shaft 2026 can be limited by contact betweenthe guide 2014 and a portion of the inner shaft 2026. In other examples,proximal translation of the inner shaft 2026 can be limited by contactbetween the jaws 2010 and 2012 (or by the limit to pivotal motion of theclamp lever with respect to the housing, as shown in FIG. 4C)

When the jaws 2010 are in the partially closed position (as shown inFIG. 20B), or when the jaws are not in a fully open position, the blade2032 can be partially extended into the jaws 2010 and 2012 such as tocut tissue between the jaws 2010 and 2012. The blade 2032 can beextended by operating a trigger of the handle (or another actuator), asdiscussed above. When the jaws 2010 are in the closed position (as shownin FIG. 20A), the blade 2032 can be fully extended into the jaws 2010and 2012 such as to cut tissue between the jaws 2010 and 2012. Usingthese operations, a physician can use the forceps 2000 to grasp tissueusing the jaws 2010 and 2012, resect tissue using the blade 2032, andremove tissue of a patient. Further details of the forceps are discussedbelow.

FIG. 22 illustrates a top view of a portion of the forceps 2000 in theopen position with the outer shaft 2028 removed, in accordance with atleast one example of this disclosure. FIG. 22 shows orientationindicators Proximal and Distal and axis A1.

The forceps 2000 of FIG. 22 can be consistent with the forceps 2000discussed above; further details are discussed with respect to FIG. 22 .For example, FIG. 22 shows that the arms 2034 a and 2034 b of the innershaft 2026 can include bores 2046 a and 2046 b, respectively, which canbe sized and shaped to receive the drive pin 2016 therein (andtherethrough in some examples).

FIG. 22 also shows that the flanges 2020 can be positioned laterallyoutward of the flanges 2022. FIG. 22 also shows that the flanges 2020can be positioned laterally inward of the arms 2034 such that a gapexists between the flanges 2022 a and 2022 b such that the arms 2034 cancontrol an outward lateral position of the flanges 2020 (and thereforethe flanges 2022). The blade 2032 can be located between the flanges2022, which allows the blade 2032 to translate parallel to the axis A1without contacting the flanges 2022 or 2020. The blade 2032 beinglocated between the flanges 2022 also allows the blade 2032 to bepositioned at or near a center of the inner shaft 2026 and the jaws 2010and 2012 so that the blade 2032 can extend along or near a centralportion of the jaws 2010 and 2012 to help improve cutting operationsusing the blade 2032. In some examples, the flanges 2022 also allow theblade 2032 to be laterally inward of the flanges 2022 while still beingoffset from the axis A1.

FIG. 22 also shows that the pivot pin 2018 and the drive pin 2016 canextend through the blade 2032. FIG. 22 further shows that the drive pin2016 can extend through the flanges 2020 and 2022 and the arms 2034.FIG. 22 further shows that the guide 2014 can define a length PL1, thedrive pin 2016 can define a length PL2, and the pivot pin 2018 candefine a length PL3. In some examples, the lengths PL1, PL2, and PL3 canall be the same to help simplify the bill of materials and constructionof the forceps 2000. However, the lengths PL1, PL2, and PL3 can bedifferent in other examples.

FIG. 23 illustrates an isometric view of the inner shaft 2026 of theforceps 2000, in accordance with at least one example of thisdisclosure. FIG. 23 also shows orientation indicators Proximal, Distal,Top, and Bottom.

The inner shaft 2026 can be consistent with the description of the innershaft 2026 above; FIG. 23 shows additional details of the inner shaft2026 such as the flats 2048 a and 2048 b (only 2048 a is visible in FIG.23 ) of the arms 2034 a and 2034 b, respectively. The flats 2048 can besized and shaped to allow the flanges 2020 and 2022 to be positionedwithin the arms 2034 and can be substantially parallel surfacesconfigured to reduce contact and friction between the flanges 2020 and2022 and the arms 2034 during opening and closing of the jaws 2010 and2012.

FIG. 23 also shows axial tracks 2050 a and 2050 b (collectively referredto as axial tracks 2050) The axial tracks 2050 can also be referred toas axial slots or channels or proximal slots of the inner shaft 2026.The axial tracks 2050 can each be axial slots extending laterallythrough walls of the inner shaft 2026. In other example, the axialtracks 2050 can be channels, grooves, recesses, or other guidesconfigured to receive a guiding member. In some examples, the axialtracks 2050 do not extend entirely through the inner shaft 2026.

The axial track 2050 a (not entirely visible in FIG. 23 ) can a includea distal edge 2052 a, a proximal edge 2054 a, a bottom edge 2056 a, anda top edge 2058 a. The axial track 2050 b can a include a distal edge2052 b, a proximal edge 2054 b, a bottom edge 2056 b, and a top edge2058 b. One or more of the axial tracks 2050 can be sized and shaped toreceive the guide 2014 therein (and therethrough in some examples) andcan be sized and shaped for the guide 2014 to translate within the axialtracks 2050 between the edges 2054 and 2056. The interaction between theguide 2014 and the axial tracks 2050 is discussed in further detailbelow.

FIG. 24 illustrates a side view of a portion of the forceps 2000 in anopen position with the outer shaft 2028 in phantom, in accordance withat least one example of this disclosure. FIG. 25 illustrates a sideisometric view of a portion of the forceps 2000, in accordance with atleast one example of this disclosure. FIGS. 24 and 25 are discussedbelow concurrently. FIGS. 24 and 25 show orientation indicatorsProximal, Distal, Top, and Bottom, and FIG. 24 shows axis A1.

FIG. 25 shows that the guide 2014 can be secured to the outer shaft 2028such as by insertion to bores 2060 a and 2060 b (only bore 2060 b isvisible in FIG. 25 ). The bores 2060 and the guide 2014 can be locatedat a distal portion of the outer shaft 2028 with respect to the forceps2000. In some examples, the bores 2060 can be substantially coaxial andcan be substantially perpendicular to the axis A1. In such cases, theguide 2014 can be positioned in the bores 2060 and can be on the axisdefined by the bores 2060, substantially perpendicular to the axis A1.The bores 2060 can also be substantially centered about the outer shaft2028 to center the guide 2014. In some examples, the bores 2060 can beoffset from the axis A1 (either above, below) and substantiallyperpendicular to the axis A1. In other examples, the bores 2060 cancross a lateral plane defined in part by the axis A1 such that one boreis above the axis A1 and one is below; the axis defined by the bores2060 can run through the axis A1 or can be offset therefrom in such aconfiguration. The axial tracks 2050 can be configured to match theorientation of the guide 2014 to allow the inner shaft 2026 to translatewith respect to the guide 2014.

FIG. 25 also shows that the pivot pin 2018 can be positioned in bores2062 a and 2062 b (only the bore 2062 b is visible in FIG. 25 ) and canbe secured therein. The orientation of the bores 2062 a and 2062 b canbe similar to any of those discussed above with respect to the guide2014 (aligned with the axis A1, offset of the axis A1, crossing the axisA1, etc.).

The guide 2014 can be affixed to the bores 2060 and the pivot pin 2018can be affixed to the bores 2062 to help prevent the pins 2014 and 2018from moving out of the bores 2060 and 2062, respectively. The pins 2014and 2018 can be secured to the bores 2060 and 2062, respectively, usingone or more of a weld (such as a laser weld), a threaded engagement, afastener, an adhesive, or the like.

In operation of some examples, when the inner shaft 2026 is translateddistally with respect to the outer shaft 2028 to move the drive pin 2016distally to move the flanges 2020 and 2022 to fully open the jaws 2010and 2012, distal translation of the inner shaft 2026 with respect to theouter shaft 2028 can be limited by contact between the guide 2014 andthe proximal edges 2054 of the axial tracks 2050 (as shown in FIG. 24 )of the inner shaft 2026 such that the guide 2014 can serve as a distalstop (or distal movement stop) for the inner shaft 2026.

In operation of some examples, when the inner shaft 2026 is translatedproximally with respect to the outer shaft 2028 to move the drive pin2016 proximally and to move the flanges 2020 and 2022 to fully close thejaws 2010 and 2012, proximal translation of the inner shaft 2026 can belimited by contact between the guide 2014 and the distal edges 2052 ofthe axial tracks 2050 of the inner shaft 2026 such that the guide 2014can serve as a proximal stop for the inner shaft 2026. In otherexamples, proximal translation of the inner shaft 2026 can be limited bycontact between the jaws 2010 and 2012 (such as the grip platesthereof).

Also, contact between the guide 2014 with one or more of the top edges2052 can help limit downward movement of the inner shaft 2026.Similarly, contact between the guide 2014 with one or more of the bottomedges 2054 can help limit upward movement of the inner shaft 2026.Contact between the guide 2014 and the top and bottom edges 2052 and2054, respectively, can also help to limit rotation of the inner shaft2026 about the axis A1 with respect to the outer shaft 2028 such as whenthe end effector is rotated at the handle (discussed above). This canhelp limit winding on the shafts 2028 and 2026, which can improveperformance of the forceps 2000 and help prevent breakage thereof.

The guide 2014 can also serve as one or more of a proximal translationstop, a distal translation stop, a vertical movement limiter, and arotation limiter for the inner shaft 2026 in examples where proximaltranslation of the inner shaft 2026 opens the jaws 2010 and 2012 anddistal translation of the inner shaft 2026 closes the jaws 2010 and2012. The guide 2014 can be any of the variations discussed aboveregarding shape, size, and placement. In some examples, the guide 2014can be engageable with the inner shaft 2026 to limit movement of thedrive shaft 2026 with respect to the outer shaft 2028 in a direction notparallel with the guide 2014. In some examples, the guide 2014 can beengageable with the inner shaft 2026 to limit movement of the driveshaft 2026 in a direction perpendicular to the guide 2014. Such aperpendicular limitation of movement by the guide 2014 can limitmovement of the shaft 2026 proximally and/or distally and/or verticallyup and/or vertically down.

FIG. 26A illustrates a side view of a portion of the forceps 2000 withthe inner shaft 2026 and the outer shaft 2028 shown in phantom and withthe blade 2032 retracted, in accordance with at least one example ofthis disclosure. FIG. 26B illustrates a side view of a portion of theforceps 2000 with the inner shaft 2026 and the outer shaft 2028 shown inphantom and with the blade 2032 advanced. FIGS. 26A and 26B also showorientation indicators Proximal, Distal, Top, and Bottom, and axis A1.FIGS. 26A and 7B are discussed below concurrently.

The forceps 2000 of FIGS. 26A and 26B can be consistent with the forceps2000 discussed above; FIGS. FIGS. 26A and 26B show additional details ofthe blade 2032. For example, FIGS. 26A and 26B show that the blade 2032can include an edge 2064, where the edge 2064 can be retracted from thejaws 2010 and 2012 when the blade 2032 is retracted and the edge 2064can extend into the jaws 2010 and 2012 (along the tracks of the jaws2010 and 2012) when the blade 2032 is extended.

In operation of some examples, the blade 2032 can be translated distallyinto tracks of the jaws 2010 and 2012 when the jaws are between the openposition and the closed position or when the jaws 2010 and 2012 are inthe closed position. The blade 2032 can be used to cut tissue or otheritems between the jaws 2010 and 2012.

FIG. 26B also shows that the blade 2032 can include a blade track 2066(or blade channel 2066) that can include a proximal edge 2068, a topedge 2070T, and a bottom edge 2070B. The track 2066 can extend most of alength of the blade 2032 along the axis A1 and can have a heightslightly larger than a diameter of the pins (2014, 2016, and 2018) toallow the blade 2032 to translate along the axis A1 past the pins.

The track 2066 can be configured to contact the guide 2014 to limitaxial translation of the blade 2032 with respect to the guide 2014 andthe outer shaft 2028. For example, the proximal edge 2068 (which can berounded complimentary to the guide 2014) can be configured to contactthe guide 2014 to limit distal translation of the blade 2032 withrespect to the inner shaft 2026, the outer shaft 2028, and the jaws 2010and 2012. In some examples, the blade track 2066 can have a lengthlonger than a length of the outer slots 2044 a and 2044 b such that theouter slots 2044 a and 2044 b do not limit translation of the blade 2032with respect to the inner shaft 2026, the outer shaft 2028, and or thejaws 2010 and 2012.

Also, contact between one or more of the guide 2014, the drive pin 2016,and the pivot pin 2018 with the top edge 2070T can help limit downwardand/or upward movement of the blade 2032 with respect to the inner shaft2026, the outer shaft 2028, and the jaws 2010 and 2012. Such contact canalso help limit rotation of the blade 2032, such as about the axis A1.Similarly, contact between one or more of the guide 2014, the drive pin2016, and the pivot pin 2018 with the bottom edge 2070B can help limitupward movement of the blade 2032 with respect to the inner shaft 2026,the outer shaft 2028, and the jaws 2010 and 2012. Such contact can alsohelp limit rotation of the blade 2032. In some examples, the guide 2014can be diametrically centered about the outer shaft 2028. In otherexamples, the guide 2014 can be offset (above, below, and/or laterally)from the axis A1.

FIG. 27 illustrates an isometric view of a portion of the forceps 2000with the inner shaft 2026 and the outer shaft 2028 shown in phantom andwith the jaws 2010 and 2012 removed, in accordance with at least oneexample of this disclosure. FIG. 27 also shows orientation indicatorsProximal, Distal, Top, and Bottom.

The forceps 2000 of FIG. 27 can be consistent with the forceps 2000discussed above; additional details of the forceps are discussed withrespect to FIG. 27 . For example, FIG. 27 shows how the proximal edge2068 of the blade track 2066 can engage the guide (shaft pin) 2014 tolimit distal translation of the blade 2032. FIG. 27 also shows a bladeshaft 2072, which can be connected to a proximal portion of the blade2032 at a location proximal of the guide 2014. The blade shaft 2072 canextend through the outer shaft 2028 and the inner shaft 2026,proximally, from the connection with the blade 2032, where the shaft2072 can connect to components of the handle, as discussed above.

FIG. 28 illustrates an isometric view of a portion of the forceps 2000with the inner shaft 2026 and the outer shaft 2028 shown in phantom, inaccordance with at least one example of this disclosure. FIG. 28 alsoshows orientation indicators Proximal, Distal, Top, and Bottom, and axisA1.

The forceps 2000 of FIG. 28 can be consistent with the forceps 2000discussed above; additional details of the forceps are discussed withrespect to FIG. 28 . For example, FIG. 28 shows that the distal plug2030 can be a distal plug securable to the outer tube 2028 between thepair of outer arms 2034 in a location proximal of the jaws 2010 and2012.

More specifically, the distal guide plug 2030 can include a body 2074, asleeve 2076, and top and bottom projections 2078T and 2078B. The body2074 can be sized for insertion within the outer shaft 2028, such thatthe sleeve 2076 extends proximally into the outer shaft 2028. Theprojections 2078T and 2078B can extend laterally outward from the body(in some examples upwards and downwards) such that the projections 2078Tand 2078B do not extend (or extend minimally) beyond an outer surface ofthe outer tube 2028. Further details of the distal guide plug 2030 arediscussed below.

FIG. 28 also shows that the guide 2014, the drive pin 2016, and thepivot pin 2018 can have diameters P1, P2, and P3, respectively. In someexamples, the diameters P1, P2, and P3 can all be the same to helpsimplify the bill of materials and construction of the forceps 2000.However, the diameters P1, P2, and P3 can be different in otherexamples.

FIG. 29A illustrates an isometric view of a portion of the forceps 2000with the inner shaft 2026 and the outer shaft 2028 shown in phantom, inaccordance with at least one example of this disclosure. FIG. 29Billustrates an isometric view of a portion of the forceps 2000 with theinner shaft 2026 and the outer shaft 2028 shown in phantom. FIG. 29Cillustrates an isometric view of a portion of the forceps 2000 with theinner shaft 2026 and the outer shaft 2028 shown in phantom. FIGS.29A-29C also show orientation indicators Proximal, Distal, Top, andBottom, a blade height BH, a blade width BW, a slot height SH, and aslot width SW. FIGS. 29A-29C are discussed below concurrently.

The forceps 2000 of FIGS. 29A-29C can be consistent with the forceps2000 discussed above; additional details of the forceps 2000 arediscussed with respect to FIGS. 29A-29C. For example, FIGS. 29A-29C showthat the projections 2078T and 2078B can extend upward and downward,respectively, from the body 2074 of the distal plug 2030. Theprojections 2078T and 2078B can be sized and shaped to nest in recesses2037 between the arms 2034 such that the projections 2078T and 2078B canform an interference fit with the outer shaft 2028 to help limitmovement of the distal guide plug 2030 with respect to the outer shaft2028. This interference fit between the guide plug 2030 and the outershaft 2028 can help to secure the guide plug 2030 to the outer shaft2028. The distal plug 2030 can be additionally (or alternatively)secured to the outer shaft 2028 using fasteners, threads, and/oradhesives.

FIGS. 29A-29C also show that the guide plug 2030 can include a bladechannel 2080, a distal face 2082, and wire routing bores 2084 and 2086.FIGS. 29A-29C also show that the blade channel 2080 can extend axiallythrough the body 2074 and show that the blade channel 2080 can extendout of a lower portion of the body 2074 such as to allow for insertionof the blade 2032 into the blade channel 2080.

The slot height SH of the blade channel 2080 can be slightly larger thanthe blade height BH of the blade 2032 to allow movement of the blade2032 through the blade channel 2080 while also helping to limit upwardand downward movement of the blade 2032 with respect to the distal guideplug 2030 and therefore the outer tube 2028. Similarly, the slot widthSW of the blade channel 2080 can be slightly wider than the blade widthBW of the blade 2032 to support movement of the blade 2032 through theblade channel 2080 while also helping limit lateral movement of theblade 2032 with respect to the distal guide plug 2030 and therefore theouter tube 2028.

FIGS. 29A-29C also show that a distal face 2082 of the guide plug 2030can be curved to allow clearance for rotation of the flanges 2020 and2022 during opening and closing of the jaws 2010 and 2012. Further, thewire routing bores 2084 and 2086 can each extend through the distal face2082 and through the body 2074 and the sleeve 2076 of the guide plug2030. Each of the wire routing bores 2084 and 2086 can be sized andshaped to receive a wire (or conduit) therein and therethrough. Each ofthe wire routing bores 2084 and 2086 can be separated from the bladechannel 2080 to help limit (or prevent or preclude) interaction betweenwires and the blade 2032.

FIG. 29C also shows that the body 2074 of the guide plug 2030 caninclude channels 2088 a and 2088 b on opposing laterally outer surfacesof the distal plug 2030. The channels 2088 can each be slots, tracks,channels, or flats configured to interface with the arms 2034 of theinner shaft 2026 such that the arms 2034 can translate past (or around)the distal plug 2030. The channels 2088 and other features of the guideplug 2030 are discussed in further detail below with respect to FIGS.30A-30C.

FIG. 30A illustrates an isometric view of a portion of the forceps 2000with the inner shaft 2026 in an extended position, in accordance with atleast one example of this disclosure. FIG. 30B illustrates an isometricview of a portion of the forceps 2000 with the inner shaft 2026 in aretracted position. FIG. 30C illustrates an end view of the guide plug2030 of the forceps 2000. FIGS. 30A-30B also show orientation indicatorsProximal, Distal, Top, and Bottom. FIG. 30C also shows orientationindicators Top and Bottom, and axis A1. FIGS. 30A-30C are discussedbelow concurrently.

The forceps 2000 of FIGS. 30A-30 can be consistent with the forceps 2000discussed above; additional details of the forceps are discussed withrespect to FIGS. 29A-29C. For example, FIG. 30B shows how the arms 2034a and 2034 b of the inner shaft 2026 can extend around and past theguide plug 2030 through the channels 2088 a and 2088 b, respectively, toallow the inner shaft 2026 to move between a distal position, as shownin FIG. 30B (closed jaws 2010 and 2012, in one example) and a proximalposition, as shown in FIG. 30A, when the inner shaft 2026 translateswithin the outer shaft 2028 to operate the end effector (such as thejaws 2010 and 2012). That is, FIGS. 30A-30B shows how the arms 2034 aand 2034 b can be moved proximally around the guide plug 2030 through(or around) the channels 2088 a and 2088 b (such as when then arms 2034are positioned laterally inward of the outer arms 2038), respectively2030, to move the inner shaft 2026 to a proximal position.

FIG. 30C shows that the channels 2088 can each be a flat; however, thechannels 2088 can be slots or other features allowing extension of thearms 2034 past the guide plug 2030. In some examples, the channels 2088can be on opposing laterally outer surfaces of the guide plug 2030.

FIG. 30C also shows that the blade channel 2080 can be offset laterallyfrom the longitudinal axis A1 of the shafts (2026 and 2028) and that thewire routing bores 2084 and 2086 can be laterally offset from the axisA1 on an opposite side from the blade channel 2080. In some examples,the distal plug 2030 can be oriented such that the blade channel 2080 isoffset in other directions from the axis A1, such as above or below.FIG. 30C also shows that the wire routing bores 2084 and 2086 can beoffset (above and below) the axis A1. However, in some examples, thewire routing bores 2084 and 2086 can be offset from the axis A1 in otherdirections, such as laterally.

FIG. 30C also clearly shows how the blade channel 2080 can extend out(or through) an end of a lower portion of the body 2074 such as to allowfor insertion of the blade 2032 into the blade channel 2080 duringassembly of the forceps 2000.

FIG. 31A illustrates an end view of a guide plug 2530 of a forceps, inaccordance with at least one example of this disclosure. The guide plug2530 can be similar to the guide plug 2030 discussed above, except thatthe blade channel 2580 of the guide plug 2530 can be merged with thewire routing bores 2584 and 2486 such that the wire routing bores 2584and 2486 are still configured to retain wires therein. Such a design canhelp to simplify manufacturing of the guide plug 2530, which can be asmall component with tight tolerances. Any of the forceps discussedabove or below can be modified to include the guide plug 2530.

FIG. 31B illustrates an end view of a guide plug 2630 of a forceps, inaccordance with at least one example of this disclosure. The guide plug2630 can be similar to the guide plug 2030 discussed above, except thatthe blade channel 2680 of the guide plug 2630 can terminate within thebody 2674. That is, the blade channel 2680 does not extend out lateral,top, or bottom sides of the guide plug 2630. Such a blade channel canhelp limit downward movement of a blade within the guide plug 2030. Anyof the forceps discussed above or below can be modified to include theguide plug 2630.

FIG. 31C illustrates an end view of a guide plug 2730 of a forceps, inaccordance with at least one example of this disclosure. FIG. 31C alsoshows orientation indicators Top and Bottom. The guide plug 2730 can besimilar to the guide plug 2030 discussed above, except that the bladechannel 2780 of the guide plug 2730 can include a projection 2784extending inward across a portion (such as a lower or laterally outerportion) of the blade channel 2780 to provide a reduced size opening2782 of the blade channel 2780 at the outward portion of the bladechannel 2780. Such a blade channel can allow a blade to be inserted intothe blade channel 2780 through the bottom portion of the guide plug2730. The projection 2784 can help to limit the bottom portion of theblade channel 2780 from moving or collapsing laterally inward andpinching the blade within the slot 2780 during operation of the forceps,which can help improve use of the forceps 2000 during an operation, forexample. Any of the forceps discussed above or below can be modified toinclude the guide plug 2730.

FIG. 32A illustrates a side view of a portion of a forceps 2700, inaccordance with at least one example of this disclosure. FIG. 32Billustrates a perspective view of a portion of the forceps 2700. FIGS.32A-32B are discussed below concurrently.

The forceps 2700 can include a top jaw 2710 (including flanges 2720), abottom jaw 2712, a guide 2714, a drive pin 2716, a pivot pin 2718, aninner shaft 2726, and an outer shaft 2728. The outer shaft 2728 caninclude outer arms 2736 a and 2736 b.

The forceps 2700 of FIGS. 32A and 32B can be similar to the forceps 2000discussed above, except that only the top jaw 2710 moves relative to thebottom jaw 2712, where the bottom jaw 2712 can be fixed relative to theinner shaft 2726 and the outer shaft 2728. In some examples, the top jaw2710 can be fixed and the bottom jaw 2712 can move.

The forceps 2700 can include any of the features discussed above withrespect to any of the other forceps except that only the flanges 2720 ofthe upper jaw 2010 are driven by the drive pin 2716 to cause the jaw2710 to move between open and closed positions as the jaw pivots aboutthe pivot pin 2718. Similarly, any of the forceps discussed above orbelow can be modified to include the components of the forceps 2700.

FIG. 33A illustrates a side view of a portion of a forceps 2800, inaccordance with at least one example of this disclosure. FIG. 33Billustrates a perspective view of a portion of the forceps 2800. FIGS.33A-33B are discussed below concurrently.

The forceps 2800 can include a top jaw 2810 (including flanges 2820 aand 2820 b), a bottom jaw 2812 (including flanges 2822 a and 2822 b), aguide 2814, a drive pin 2816, a pivot pin 2818, an inner shaft 2826, andan outer shaft 2828. The outer shaft 2828 can include outer arms 2836 aand 2836 b.

The forceps 2800 of FIGS. 33A and 33B can be similar to the forcepsdiscussed above, except that the flanges 2822 can be interlaced with theflanges 2820, which can allow for jaw assemblies (2010 and 2012) to bethe same component, which can help reduce cost. In such an example, theblade 2832 can be positioned between one of the flanges 2822 and one ofthe flanges 2820. The forceps 2800 can include any of the featuresdiscussed above with respect to any of the other forceps. Similarly, anyof the forceps discussed above or below can be modified to include thecomponents of the forceps 2800.

FIG. 34A illustrates a side view of a portion of a forceps 2900, inaccordance with at least one example of this disclosure. FIG. 34Billustrates a perspective view of a portion of the forceps 2900. Theforceps 2900 can include any of the features discussed above withrespect to the other forceps.

FIG. 35A illustrates a side view of a flange 3022A of a forceps, inaccordance with at least one example of this disclosure. FIG. 35Billustrates a side view of a flange 3022B of the forceps. FIG. 35Cillustrates a side view of a flange 3022C of the forceps. FIGS. 35A-35Calso show orientation indicators Proximal, Distal, Top, and Bottom.FIGS. 35A-35C are discussed below concurrently.

FIGS. 35A-35C show the flanges 3022A, 3022B, and 3022C, respectively,which can each include a pivot bore 3090 extending into or through theflange 3022. The pivot bore 3090 can be configured to receive a pivotpin (such as the pivot pin 2018) therethrough to secure the flanges 3022to an outer shaft such that the flanges 3022 can pivot about the outershaft.

FIGS. 35A-35C also show a curved proximal portion 3092 adjacent a topedge 3094 of the flanges 3022A, 3022B, and 3022C. The curved proximalportions 3092 can each be rounded or curved (or otherwise shaped orprofiled) to provide a reduced lateral extension of the flange 3022 whenthe jaw is in the open position. The curved proximal portion 3092 of theflange 3022A can have a relatively small radius, whereas the curvedproximal portion 3092 of the flange 3022C can have a relatively largeradius that is not concentric with a curvature of a proximal end 3093 ofa track 3042 of the flange 3022C. That is, a center of curvature C1 ofthe proximal end 3093 can be non-concentric with a center of curvatureC2 of the curved proximal portion 3092. The relatively large radius ofthe curved proximal portion of the flange 3022C can further help toreduce lateral extension of the flange 3022C when the jaw is in the openposition

FIGS. 35A-16C also show that a top portion of the flange can be removedto further limit lateral extension of the flange 3022 when the jaw is inthe open position. For example, the edge 3094 of FIGS. 35B and 16C canbe moved laterally (or downward) by about 0.5 millimeters, as shown inFIG. 35A. In other examples, the edge 3094 can be moved down more orless, depending on the materials and sizes and shapes of the flange3022, such as based on stresses applied to the flange from operationthereof. The forceps of FIGS. 35A-16C can include any of the featuresdiscussed above with respect to any of the other forceps. Similarly, anyof the forceps discussed above or below can be modified to include thecomponents of the forceps of FIGS. 35A-35C.

FIG. 36A illustrates a side view of a portion of a forceps 3000A, inaccordance with at least one example of this disclosure. FIG. 36Billustrates a side view of a portion of a forceps 3000C. FIG. 36Cillustrates a side view of a portion of the forceps 3000C. FIGS. 36A-36Calso show orientation indicators Proximal, Distal, Top, and Bottom.FIGS. 36A-36C are discussed below concurrently.

The forceps 3000A can include the flange 3022A of FIG. 16A and variouscomponents similar to forceps discussed above, such as an upper jaw3010, a lower jaw 3012, a drive pin 3016, a pivot pin 3018, an innershaft 3026, an outer shaft 3028, and outer arms 3036. FIG. 36A shows howthe proximal rounded portion 3092A of the flange 3022A extends laterallyoutward (or upward) beyond the outer shaft 3028 when the jaws 3010 and3012 are in the open position.

The forceps 3000C, as shown in FIGS. 36B and 17C show how extension ofthe flange 3022C laterally beyond the outer shaft 3028 can be reduced bythe curved proximal portion 3092 of the flange 3022C. Such a reductionin lateral extension can help reduce contact between the flanges 3020and 3022 and tissues within a cavity, and therefore can help reduceinterference by the flanges 3020 and 3022 with tissue.

The proximal rounded portions of flanges are discussed in further detailbelow with regard to the forceps 2000. The forceps 3000 can include anyof the features discussed above with respect to any of the otherforceps. Similarly, any of the forceps discussed above or below can bemodified to include the components of the forceps 3000.

FIG. 37A illustrates a side view of a portion of a forceps 3200, inaccordance with at least one example of this disclosure. FIG. 38illustrates a side view of a portion of a forceps 3300, in accordancewith at least one example of this disclosure. FIG. 38 illustrates a sideview of a portion of the forceps 3300, in accordance with at least oneexample of this disclosure. FIGS. 37A-38 are discussed belowconcurrently.

The forceps 3200 can include an upper jaw 3210, a lower jaw 3212, a andan outer shaft 3228. The lower jaw can include a flange 3222. Similarly,the forceps 3300 can include an upper jaw 3310, a lower jaw 3312, a andan outer shaft 3328. FIGS. 37A and 37B show how rounded proximal portion3292 of the flange 3222 of the lower jaw 3212 can reduce extension ofthe flange laterally beyond an outer surface of the outer shaft 3228over the less-rounded proximal portion 3392 of the flange 3322.

FIG. 39A illustrates a side view of a portion of a forceps 3400, inaccordance with at least one example of this disclosure. FIG. 39Billustrates a side view of a portion of a forceps 3500, in accordancewith at least one example of this disclosure. FIG. 39C illustrates aside view of a portion of a forceps 3600, in accordance with at leastone example of this disclosure. FIGS. 39A-39C are discussed belowconcurrently.

FIG. 39A shows a forceps 3400 including an upper jaw 3410 in twopositions indicated by 3410 a and 3410 b, the jaw 3410 including aflange 3420 in two positions, indicated by 3420 a and 3420 b. Theforceps can also include a lower jaw 31484, which can be fixed, and anouter shaft 3428. Also shown in FIG. 39A are distances E1, E2, O1, andO2.

FIG. 39A shows how when the upper jaw 3410 is in a first open positionat 3410 a, a distance between jaws can be O1, which can be 14.5millimeters, in one example. In a second open position at 3410 b, adistance between jaws can be O2, which can be 16.5 millimeters, in oneexample, a difference of about 2 millimeters. When the jaw 3410 is inthe first open position at 3410 a, the flange 3420 can be at a firstposition 3420 a having a distance E1 from the outer shaft 3428 of about2.3 millimeters, in one example. When the jaw 3410 is in the second openposition at 3410 b, the flange 3420 can be at a second position 3420 bhaving a distance E2 from the outer shaft 3428 of about 3 millimeters,in one example, a difference of about 0.7 millimeters between positions.

That means a 0.7 millimeter difference in flange extension correspondsto a 2.0 millimeter difference in opening, where a larger openingbetween the jaws 2010 and 2012 can provide better range of operation ofthe forceps 3400. However, it is undesirable to have a flange thatextends beyond an outer surface of the outer shaft 3428 more thannecessary, because the flange 3420 can engage surrounding tissue.Therefore, as shown in FIG. 39C, the flange 3620 can have a proximalrounded portion 3692 configured to reduce an amount that the flange 3620extends beyond an outer surface of the outer shaft 3628 as compared tothe flange 3520 of the forceps 3500 of FIG. 39B, which can extendrelatively further outward than the flange 3620 of the forceps 3600 ofFIG. 39C.

FIG. 40A illustrates a side view of a jaw 3710, in accordance with atleast one example of this disclosure. FIG. 40B illustrates a side viewof the jaw 3710. FIG. 40C illustrates an end view of the jaw 3710. FIG.40D illustrates an isometric view of the jaw 3710. FIGS. 40B and 40Cshow an axis A1 and FIG. 40C shows a vertical plane P1. FIGS. 40A-40Dare discussed below concurrently.

The jaw 3710 can be similar to other jaws discussed above in that thejaw 3710 can include flanges 3720 a and 3720 b including tracks 3740 aand 3740 b and a pivot pin bore 3790. FIGS. 40A-40D also show that thejaw 3710 can have an outer shell 3795 which can be relatively round andsmooth to help limit snagging or catching on tissue. FIG. 40B also showsthat the jaw 3710 can be curved with respect to the axis A1. FIGS. 40Band 40D also show a top wire 3738 that can be connected to an electrodeof the jaw 3710 to provide power thereto. The jaw 3710 can include anyof the features discussed above with respect to any of the forceps.Similarly, any of the forceps discussed above or below can be modifiedto include the components of the jaw 3710.

FIG. 41A illustrates an isometric view of a jaw 3712, in accordance withat least one example of this disclosure. FIG. 41B illustrates a sideview of the jaw 3712. FIG. 41C illustrates a side view of the jaw 3712.FIG. 41D illustrates an end view of the jaw 3712. FIGS. 41C and 22D showan axis A1. FIGS. 41A-22D are discussed below concurrently.

The jaw 3712 can be similar to other jaws discussed above in that thejaw 3712 can include flanges 3722 a and 3722 b having tracks 3742 a and3742 b and a pivot pin bore 3790. FIGS. 40A-40D show that the jaw 3710can have an outer shell 3797 which can be relatively round and smooth tohelp to limit (or prevent or preclude) snagging or catching of the jaw3712 on tissue. FIG. 41C also shows that the jaw 3710 can be curved withrespect to the axis A1. FIG. 41C further shows a bottom wire 3799 thatcan be connected to an electrode of the jaw 3712 to provide powerthereto.

FIG. 41A also shows that the plate 3724 of the jaw 3712 can include ablade slot 3725, which can extend along the plate 3724 of the jaw 3712and can be configured to receive a blade (such as the blade 2032)therein. In some examples, the blade slot 3725 can be curved with theprofile of the jaw 3712. Each of the jaws discussed above and below caninclude such a blade slot. In some examples, the jaw 3710 can include ablade slot 3723 that can be complimentary to the blade slot 3725. Thatis, the blade slots 3725 and 3723 can be parallel such that each of thejaws 3710 and 3712 (when operating together) can receive a blade thereinwhen the jaws 3710 and 3712 are in a closed position or partially closedposition.

The jaw 3712 can include any of the features discussed above withrespect to any of the other forceps. Similarly, any of the forcepsdiscussed above or below can be modified to include the components ofthe jaw 3712.

FIG. 42 illustrates a side view of a portion of the forceps 2000 in aclosed position with the inner shaft 2026 and the outer shaft 2028 shownin phantom, in accordance with at least one example of this disclosure.FIG. 43 illustrates a side view of a portion of the forceps 2000 in anopen position with the inner shaft 2026 and the outer shaft 2028 shownin phantom. FIG. 44 illustrates a focused side view of a portion of theforceps 2000. FIG. 42 shows section indicators C1-C1 and C2-C2. FIGS.42-44 show orientation indicators Proximal and Distal. FIG. 44 alsoshows angle θ. FIGS. 42-44 are discussed below concurrently.

The forceps 2000 of FIGS. 42-44 can be consistent with the forceps 2000discussed above; further details are discussed below with respect toFIGS. 42-44 . For example, FIGS. 43 and 44 show that the flange 2020 bcan include the track 2040 b, a rounded proximal portion 2092, an outer(or bottom) edge 2094, a top (or inner or upper) edge 2100, and aproximal inner portion 2102. The track 2040 b can include a proximal end2104.

The rounded proximal portion 2092 can be connected to the bottom edge2094 and the proximal inner portion 2102, such as proximal of a jawpivot axis, which can be defined by the pivot pin 2018. The proximalinner portion 2102 can be connected to the top (or inner) edge 2100. Theproximal end 2104 can be a portion of the slot 2040 b that can include atermination of the slot 2040 b. The proximal end 2104 can be locatednear the rounded proximal portion 2092.

The rounded proximal portion 2092 can be shaped, such as rounded orcurved, as can the proximal inner portion 2102. The rounded proximalportion 2092 can be curved or can have a radiused edge from a lateralperspective (as shown in FIG. 44 ) to help limit extension of therounded proximal portion 2092 beyond the outer shaft 2028 when the jaws2010 and 2012 are in the open position (or between the open and closedpositions). That is, one or more of the proximal portions 2092 of theflanges 2020 and 2022 can be shaped to limit extension of the proximalportions 2092 laterally beyond the arms 2038 of the outer shaft 2028,which can help limit engagement between the flanges 2020 and 2022 withsurrounding tissues during a procedure. In some examples, such a roundedproximal portion 2092 can be used with only one flange 2020 and oneflange 2022.

In some examples, the rounded proximal portion 2092 can be curved or canhave a radiused edge from a lateral perspective that is greater than aradius of the proximal inner portion 2102 from a lateral perspective. Inother words, the inner proximal portion 2102 can be rounded at a radiussmaller than a radius of the rounded proximal portions 2092. In someexamples, the rounded proximal portion 2092 can be located near thetrack 2040. The rounded proximal portion 2092 can be profiled to limitstress in the flange 2020 where the stress can be produced byinteraction between the track 2040 (the flange 2020) and the inner shaft2026, such as through the drive pin 2016.

The proximal end 2104 of the track 2040 can be a termination of thetrack 2040 and can have a curved or radiused shape. In some examples,the rounded proximal portion 2092 can have a curvature not concentricwith a curvature of the proximal end 2104 of the track 2040. In someexamples, the rounded proximal portion 2092 can have a radius as largeas possible to reduce extension (such as a reduced radial extension) ofthe flange 2020 beyond the outer shaft 2028 without reducing a strengthof the flange 2020 adjacent the track 2040 below what is required fornormal operation of the flange 2020 (for example to withstand forcesapplied by drive pin 2016). FIG. 42 also shows that when the jaws 2010and 2012 are in the closed position, the flanges 2020 and 2022 do notextend laterally beyond the outer shaft 2028.

In some examples, the profile of the proximal portion 2092 can beconfigured to maintain a minimum thickness between the track 2040 andthe proximal portion 2092. In some examples, the minimum thickness canbe between 0.1 millimeters and 1.5 millimeters. In other examples, theminimum thickness can be between 0.3 millimeters and 1 millimeter. Inother examples, the minimum thickness can be 0.7 millimeters.

In some examples, the profile of the proximal portion 2092 of the flange2020 can include an edge 2103 having an arc that is tangent to the outeredge 2094. In some examples, the arc of the edge 2103 can be eccentricwith an arc of the proximal end 2104 of the track 2040 b. In someexamples, the arc of the edge 2103 can have a radius of curvature thatis larger toward a laterally inner portion (toward the inner roundedportion 102) than a laterally outer portion (toward the rounded proximalportion 2092) when the flanges 2020 and/or 2022 are in the open position(or are not in the closed position). In any of the examples discussedherein, the flange 2020 can be symmetric about one or more axes.

FIG. 44 also shows the angle θ, which can be an angle formed between atop surface of the outer arms 2034 and the flange 2022 b. (The flanges2020 can form similar angles with a bottom surface of the outer arms2034.) The rounded proximal portion 2092 of the flange 2022 can, atleast in part, define the angle θ. In some examples, the roundedproximal portion 2092 can have a curvature to limit (or prevent orpreclude) the angle θ from becoming an acute angle, such as when theflange 2022 (or the flange 2020) are in the open position. Minimizingthe angle θ can help to limit pinching or scissoring of tissue betweenthe flange 2022 and the outer arm 2034 during opening and closing of thejaws 2010 and 2012. Also, the proximal inner portion 2102 can beprevented (by positioning of the tracks 2042, for example) fromextending laterally beyond (such as above) the top surface of the outerarm 2034, which can further help limit unwanted pinching or scissoringof tissue during opening and closing of the jaws 2010 and 2012. In someexamples, a transition between the proximal inner portion 2102 and theproximal inner portion 2102 can be curved or rounded to further preventscissoring.

FIG. 45 illustrates a cross-section view of a portion of the forceps2000 across section C1-C1 of FIG. 42 . FIG. 46 illustrates across-section view of a portion of the forceps 2000 across section C2-C2of FIG. 42 . FIG. 47 illustrates a side view of a portion of the forceps2000 with the inner shaft 2026 and the outer shaft shown in phantom2028. FIGS. 45-47 are discussed below concurrently.

The forceps 2000 of FIGS. 45 and 46 can be consistent with thedescriptions of the forceps 2000 discussed above; FIGS. 45 and 46 showdetails of a chamfer of the flanges 2020 of the jaw 2010. Morespecifically, FIGS. 45 and 46 show the flanges 2020 a and 2020 b and2022 a and 2022 b. Also shown is the inner shaft 2026 including the arms2034 a and 2034 b and the outer shaft 2028 including the arms 2034 a and2034 b and including an outer surface 2106.

Also shown are the blade 2032 in the blade channel 2080 of the guideplug 2030 offset from the axis A1 and the wire routing bores 2084 and2086 of the guide plug 2030 offset from the axis A1 opposite the blade2032. FIG. 45 also shows the drive pin 2016 and FIG. 46 shows the shaftpin 2014. FIGS. 45 and 46 also show further details of the flanges 2020a and 2020 b, such as the upper edges 2102 a and 2102 b, respectively,an outer surface 2108 a and 2108 b, respectively, and chamfers 2110 aand 2110 b, respectively.

Also shown in FIG. 45 is a diameter D1, which can be an inner diameterof the outer shaft 2028, and a diameter D2, which can be an outerdiameter of the inner shaft 2026. FIG. 45 shows how diameter D2 issmaller than the diameter D1 such that the inner shaft 2026 and the arms2034 of the inner shaft 2026 fit within the outer shaft 2028, enablingrelative translation of the inner shaft 2026 with respect to the outershaft 2028.

As shown in FIGS. 45 and 46 , the chamfer 2110 a can extend between theouter surface 2108 a and the upper edge 2102 a. Similarly, the chamfer2110 b can extend between the outer surface 2108 b and the upper edge2102 b. The chamfers 2110 can be sized and shaped to limit extension ofthe flanges 2020 of the jaw 2010 laterally beyond the outer surface ofthe outer shaft 2028 when the jaws 2010 and 2012 are in the closedposition, helping to reduce the overall profile of the end effector2002, which can help make insertion of the end effector 2202 into acannula and/or opening easier.

In some examples, one or more of the chamfers 2110 can be a bevelextending between the upper edges 2102 and the outer surfaces 2108. Inother examples, the chamfers 2110 can be curved or notched surfaces ofthe flanges 2020, configured to limit extension of the flanges 2020beyond the outer surface 2106 of the outer shaft 2028. In some examples,one or more of the chamfers 2110 can be rounded.

As shown in FIG. 47 , the chamfers 2110 can be located with respect tothe tracks 2040 to extend a thickness of the flange 2020 adjacent adistal termination of the track, which can help increase a strength ofthe flange 2020 where the drive pin 2016 can apply a force to the track2040. In other examples, where the track 2040 is reversed, the chamfers2110 can be located with respect to the tracks 2040 to extend athickness of the flange 2020 adjacent the distal end 2104 of the tracks2040.

In some examples, one or more of the flanges 2022 a and 2022 b caninclude a chamfered outer edge configured to limit extension of theflanges 2022 beyond the outer surface 2106 of the outer shaft 2028. Inan example where the flanges 2020 and 2022 are staggered, any one of theflanges 2020 and 2022 can include a chamfered edge configured to limitextension of the flanges 2022 beyond the outer surface 2106 of the outershaft 2028.

As shown in FIG. 46 the chamfers 2110 a and 2110 b can be further awayfrom the outer surface at a more proximal position of the flanges 2020 aand 2020 b, respectively. That is, the chamfers 2110 a and 2110 b candefine edges extending substantially axially along the flanges 2020 whenthe jaws 2010 and 2012 are in the closed position. The edges (chamfers2110) can be located laterally inward (or radially inward, in someexamples) of the outer surface 2106 of the outer tube 2028.

In some examples, the chamfers 2110 (or chamfered edges) can be angledlaterally inward (or radially inward) from an axially distal location toan axially proximal location. In operation of the forceps 2000,application of a larger force to compress the jaws 2010 and 2012 cancause proximal portions of the flanges 2020 and 2022 to extend radiallyoutward beyond the outer surface of the outer shaft 2028. This effectcan cause the flanges to engage a trocar during removal of the forcepsfrom the trocar with the tissue grasped, which can complicate theprocedure removal. The chamfers 2110 (or chamfered edges) being angledlaterally inward (or radially inward) from an axially distal location toan axially proximal location (or the chamfered edges 2110 having abackwards rake) can help reduce lateral extension of the flanges 2020and 2022 beyond the outer shaft 2028 caused by application of a largeforce on an actuator, which can help avoid engagement with a trocar (ortissue or other component) during removal of the forceps 2000 from acavity.

FIG. 48 illustrates a cross-section view of a portion of a forceps 4000across section 45-45 of FIG. 42 , in accordance with at least oneexample of this disclosure. The forceps 4000 can be similar to thosediscussed above, where the forceps can include the jaws 4010 and 4012including flanges 4020 and 4022, respectively. The forceps 4000 can alsoinclude an inner shaft 4026 including inner arms 4034 a and 4034 b andthe forceps 4000 can include an outer shaft 4028 including outer arms4036 a and 4036 b.

FIG. 48 also shows that the flanges 4020 and 4022 can form a channeltherebetween that can be configured (such as sized and shaped) toreceive a blade 4032 and wires 4098 and 4099 therethrough. In someexamples, the wires 4098 and 4099 can extend axially through the firstset of flanges 4020 and the second set of flanges 4022 in a positionlaterally inward of the first set of flanges 4020 and the second set offlanges 4022.

One wire, such as the wire 4098 can be above an axis A1 of the shafts,and another wire, such as the wire 4099, can be below the axis A1. Insome examples, the wire 4098 can be above a drive pin (to be routed tothe upper jaw 4010) and the wire 4099 can be below the drive pin (to berouted to the lower jaw 4012). In some examples, the blade 4032 can beoffset (such as laterally offset) from the axis A1 and the wires 4098and 4099 can be offset (such as laterally offset) from the axis A1 onthe opposite side from the blade 4032. In some examples, the axis A1 canbe a central axis of the inner shaft 4026 where the blade 4032 canextend through the inner shaft 4026 along the axis A1.

FIG. 49 illustrates a cross-section view of a portion of a forceps 4100across section 46-46 of FIG. 42 , in accordance with at least oneexample of this disclosure.

The forceps 4100 can be similar to other forceps discussed above, wherethe forceps can include the jaws 4110 and 4112 including flanges 4120and 4122, respectively. The forceps 4100 can also include an inner shaft4126 including inner arms 4134 a and 4134 b and the forceps 4100 caninclude an outer shaft 4128 including outer arms 4136 a and 4136 b.

FIG. 49 also shows that the flanges 4120 and 4122 can form a channeltherebetween that can receive a blade 4132. The flanges 4120 and 4122can also form laterally outer channels for the wires 4198 and 4199,respectively, such that the wires 4198 can be positioned laterallyoutward of the flanges 4120 and 4122 and laterally inward of the arms4134 and 4136. One wire, such as the wire 4098 can be above an axis A1of the shafts to be routed to the upper jaw 4110, and another wire, suchas the wire 4199, can be below the axis A1 to be routed to the lower jaw4112. In some examples, the wire 4198 can be above a drive pin 4116 andthe wire 4199 can be below the drive pin 4116. In some examples of thisconfiguration, the flanges 4120 and 4122 can be interlaced.

FIG. 50 illustrates a side isometric view of a portion of a forceps2000, in accordance with at least one example of this disclosure. Theforceps 2000 can be consistent with the forceps 2000 discussed above.FIG. 50 shows that a guide tube 2112 (or lumen 2112) can be positionedwithin the inner shaft 2026 and the outer shaft 2028 and can extendthrough the outer shaft 2028 and the inner shaft 2026 between the endeffector 2002 and the handle 2001. More specifically, the guide tube2112 can extend from a distal position just off a proximal edge of theblade 2032 when the blade is in the retracted position and can extendproximally to a position or location distal of a clip (such as the clip1056) that holds a slider block (such as the drive body 1052) to thedrive shaft or inner shaft 2026.

FIG. 51A illustrates an end isometric view of a portion of the forceps2000, in accordance with at least one example of this disclosure. FIG.51B illustrates an end isometric view of a portion of the forceps 2000.FIGS. 51A and 32B are discussed below concurrently.

The forceps 2000 can be consistent with the descriptions above; FIGS.51A and 32B show additional details. For example, FIGS. 51A-51B show aguide tube 2112 that can include a body 2114 defining a blade bore 2116and a wire routing bore 2118. Also shown in FIGS. 51A and 32B areorientation indicators Proximal and Distal and axis A1.

The body 2114 can extend along the axis A1 and can be substantiallycylindrical in some examples, but can have other shapes in otherexamples, such as an oval prism, a rectangular prism, a hexagonal prism,an octagonal prism, or the like. The body 2114 can be configured, suchas sized and shaped, to be complimentary to an internal bore of theinner shaft 2026 to form a pneumatic seal with the inner shaft 2026.

The blade bore 2116 and the wire routing bore 2118 can each be boresextending axially through the body 2114 along the axis A1. The bladebore 2116 can be sized and shaped to receive the shaft 2072 of the blade2032 therethrough and can be configured to allow for translation of theshaft 2072 within the guide tube 2112 to allow the blade 2032 to beoperated from the handle 2001 such that the blade 2032 can translatewithin the blade channels of the jaws 2010 and 2012. The blade bore 2116can also be sized relative to the blade shaft 2072 such that a pneumaticseal, or a seal, can be formed between the blade bore 2116 and the bladeshaft 2072 to help reduce pressurized air or gas from traveling throughthe body 2114.

The wire routing bore 2118 can be sized and shaped to receive one ormore wires or conduits therethrough to allow for conduits to extend fromthe handle 2001 to electrodes of the jaws 2010 and 2012. In someexamples, the guide tube 2112 can be formed of a non-conductivematerial. In some examples, the guide tube 2112 can be formed by anextrusion. The wire routing bore 2118 can also be sized relative to theconduit(s) such that a pneumatic seal, or a seal, can be formed betweenthe wire routing bore 2118 and the conduit(s) to help reduce pressurizedair or gas from traveling through the body 2114.

FIG. 52A illustrates an end isometric view of the guide tube 2112 andthe blade shaft 2072, in accordance with at least one example of thisdisclosure. FIG. 52B illustrates an end view of the guide tube 2112 e.Also shown in FIGS. 52A and 33B are orientation indicators Proximal andDistal and the axis A1. FIGS. 52A and 52B are discussed belowconcurrently.

The guide tube 2112 can be consistent with the descriptions above; FIGS.52A and 33B show additional details of the guide tube 2112. For example,FIGS. 52A-52B show that the blade bore 2116 and/or the wire routing bore2118 of the guide tube 2112 can extend axially through the body 2114 ofthe guide tube 2112. In some examples, one or more of the blade bore2116 and the wire routing bore 2118 can extend through the guide tube2112 axially parallel to the axis A1. In some examples, the blade bore2116 can be offset of the axis A1. In some examples, the wire routingbore 2118 can be offset of the axis A1 opposite the blade channel, asshown in FIG. 52B.

In one example, the guide tube 2112 can include a second wire routingbore extending therethrough configured to receive a second conduittherethrough. The second wire routing bore can be offset of the axis A1opposite the blade channel 2116. The second wire routing bore can beoffset of the longitudinal axis and the second wire routing bore offsetan opposite side of the longitudinal axis from the wire routing bore.

FIG. 53 . illustrates an exploded view of the jaw 2012. The jaw 2012 caninclude the grip plate 2024 (including a blade slot 2025), a wire 2099,a frame 2120 (including flanges 2022 a and 2022 b), an overmold 2122(including a blade slot 2125), and a support 2124.

The jaw 2012 can be consistent with the description above; FIG. 53 showsadditional details of the jaw 2012. For example, FIG. 53 shows that theovermold 2122 can include a blade slot 2125, which can be aligned withthe blade slot 2025 of the grip plate 2024 when the overmold 2122 issecured to the grip plate 2024 (such as when the overmold 2122 isovermolded to the frame 2120 and the grip plate 2024. FIG. 53 also showsthat the frame 2120 can include a slot 2126 that can receive the support2124 therein. The support 2124 can help to support the grip plate 2024on the frame 2120.

FIG. 53 also shows that the grip plate 2024 can include teeth 2128 thatcan define recesses 2130. The recesses 2130 can be located on a sideedge of the grip plate 2024. The recesses 2130 can be configured to letmaterial of the overmold 2122 infiltrate (or fill in) the recesses (orspaces or gaps) 2130 so that the grip plate 2024 is secured to theovermold 2122. The grip plate 2024 can also be an electrode (or caninclude an electrode) which can be electrically connected to the wire(or conduit) 2099.

NOTES

While illustrative examples of a medical device are shown and describedin this disclosure with respect to a forceps, the features can be usedin other medical devices besides forceps for controlling end effectorsused in diagnosis, treatment or surgery. Any representation of a forcepsor description thereto is shown primarily for illustrative purposes todisclose features of various examples.

The forceps illustrated in the examples can be an electrosurgicaldevice, however, the forceps may be any type of medical device thatfacilitates mechanical and/or electrical actuation of one or more endeffectors or other elements arranged distal from the handpiece havingone or more actuation systems. The actuation systems described, whichcan extend, retract or rotate one or more shafts to produce this result,can be used to effect actions in other medical devices (e.g., medicalinstruments).

The directional descriptors described herein are used with their normaland customary use in the art. For example, proximal, distal, lateral,up, down, top and bottom may be used to describe the apparatus with thelongitudinal axis arranged parallel to a ground with the device in anupright position. The proximal direction refers to a direction towardsthe user end of the apparatus, and the distal direction represents adirection towards the patient end of the apparatus.

Relative terms described herein, such as, “about” or “substantially” maybe used to indicate a possible variation of ±10% in a stated numericvalue, or a manufacturing variation.

As described throughout this disclosure, components and assemblies canbe operably connected to each other and interact with one another in amanner that provides improved actuation, a more compact and simplerdesign, lower cost, and better user satisfaction than traditionalmedical devices.

The above detailed description includes references to the accompanyingdrawings, which form a part of the detailed description. The drawingsshow, by way of illustration, specific embodiments in which theinvention can be practiced. These embodiments are also referred toherein as “examples.” Such examples can include elements in addition tothose shown or described. However, the present inventor alsocontemplates examples in which only those elements shown or describedare provided. Moreover, the present inventor also contemplates examplesusing any combination or permutation of those elements shown ordescribed (or one or more aspects thereof), either with respect to aparticular example (or one or more aspects thereof), or with respect toother examples (or one or more aspects thereof) shown or describedherein.

In this document, the terms “a” or “an” are used, as is common in patentdocuments, to include one or more than one, independent of any otherinstances or usages of “at least one” or “one or more.” In thisdocument, the term “or” is used to refer to a nonexclusive or, such that“A or B” includes “A but not B,” “B but not A,” and “A and B,” unlessotherwise indicated. In this document, the terms “including” and “inwhich” are used as the plain-English equivalents of the respective terms“comprising” and “wherein.” Also, in the following claims, the terms“including” and “comprising” are open-ended, that is, a system, device,article, composition, formulation, or process that includes elements inaddition to those listed after such a term in a claim are still deemedto fall within the scope of that claim. Moreover, in the followingclaims, the terms “first,” “second,” and “third,” etc. are used merelyas labels, and are not intended to impose numerical requirements ontheir objects.

In the event of inconsistent usages between this document and anydocuments so incorporated by reference, the usage in this documentcontrols. In this document, the terms “including” and “in which” areused as the plain-English equivalents of the respective terms“comprising” and “wherein.” Also, in the following claims, the terms“including” and “comprising” are open-ended, that is, a system, device,article, composition, formulation, or process that includes elements inaddition to those listed after such a term in a claim are still deemedto fall within the scope of that claim.

The above description is intended to be illustrative, and notrestrictive. For example, the above-described examples (or one or moreaspects thereof) may be used in combination with each other. Otherembodiments can be used, such as by one of ordinary skill in the artupon reviewing the above description. The Abstract is provided to complywith 37 C.F.R. § 1.72(b), to allow the reader to quickly ascertain thenature of the technical disclosure. It is submitted with theunderstanding that it will not be used to interpret or limit the scopeor meaning of the claims. Also, in the above Detailed Description,various features may be grouped together to streamline the disclosure.This should not be interpreted as intending that an unclaimed disclosedfeature is essential to any claim. Rather, inventive subject matter maylie in less than all features of a particular disclosed embodiment.Thus, the following claims are hereby incorporated into the DetailedDescription as examples or embodiments, with each claim standing on itsown as a separate embodiment, and it is contemplated that suchembodiments can be combined with each other in various combinations orpermutations. The scope of the invention should be determined withreference to the appended claims, along with the full scope ofequivalents to which such claims are entitled.

The invention claimed is:
 1. A forceps comprising: an outer tubeextending along a longitudinal axis, the outer tube including a pair ofouter arms extending from a distal portion of the outer tube; a firstjaw pivotably connected to the outer tube, the first jaw including afirst flange and a second flange each located at a proximal portion ofthe first jaw, the first flange and the second flange each including aproximal portion extending outward of the outer tube when the jaws arein an open position, the proximal portions shaped to limit extension ofthe proximal portions laterally beyond the outer arms; a second jawconnected to the outer tube; and an inner tube located within the outertube and extending along the longitudinal axis, the inner tube connectedto the first flange and the second flange, the inner tube translatablealong the outer tube to drive the first flange and the second flange tomove the first jaw and the second jaw between the open position and aclosed position.
 2. The forceps of claim 1, wherein the shaped profileof the proximal portions of the first flange and the second flange areradiused.
 3. The forceps of claim 2, wherein the first flange and thesecond flange each include a track configured to receive a drive pintherein, the drive pin movable along the tracks by the inner tube tomove the jaws between the open and closed positions, and wherein acurvature of the proximal portions is not concentric with a curvature ofa proximal end of the tracks.
 4. The forceps of claim 1, wherein theproximal portions are configured to extend laterally outward of theouter tube when the jaws are in the open position, the proximal portionsrounded to provide a reduced radial extension of the first flange andthe second flange when the jaws are in the open position.
 5. The forcepsof claim 4, wherein the first flange and the second flange each includean inner proximal portion extending inward of the outer arms when thejaws are in the open position, wherein the inner proximal portions arerounded at a radius smaller than a radius of the proximal portions. 6.The forceps of claim 5, wherein the proximal portion and the innerproximal portion are connected to limit forming an acute angle with therespective outer arms when the jaws are moved between the open andclosed positions.
 7. The forceps of claim 6, wherein the proximalportion and the inner proximal portion are connected to preclude formingan acute angle with the respective outer arms when the jaws are movedbetween the open and closed positions.
 8. The forceps of claim 7,wherein the second jaw includes a third flange and a fourth flange eachlocated at a proximal portion of the second jaw.
 9. The forceps of claim8, wherein the third flange and the fourth flange each include aproximal portion extending outward of the outer tube opposite theproximal portions of the first flange and the second flange when thejaws are in the open position, the proximal portions of the third flangeand the fourth flange rounded to reduce radial extension of the thirdflange and the fourth flange when the jaws are in the open position. 10.The forceps of claim 9, further comprising: a drive pin; wherein thefirst flange, the second flange, the third flange and the fourth flangeeach include a track receiving the drive pin; wherein the inner tubecomprises a pair of inner arms extending from a distal portion of theinner tube, the drive pin securable to the inner arms, and the innertube translatable with respect to the outer tube to drive the drive pinalong the tracks to move the first jaw and the second jaw between openand closed positions.
 11. A forceps comprising: an outer tube extendingalong a longitudinal axis, the outer tube including a pair of outer armsextending from a distal portion of the outer tube; a first jaw pivotablyconnected to the outer tube, the first jaw including a first flange anda second flange each located at a proximal portion of the first jaw, thefirst flange and the second flange each including a proximal portionextending outward of the outer tube when the jaws are in an openposition, the proximal portions profiled to limit extension of theproximal portions laterally beyond the outer arms when the first jaw isin an open position; a second jaw connected to the outer tube; and aninner tube located within the outer tube and extending along thelongitudinal axis, the inner tube connected to the first flange and thesecond flange, the inner tube translatable along the outer tube to drivethe first flange and the second flange to move the first jaw and thesecond jaw between the open position and a closed position.
 12. Theforceps of claim 11, wherein the first flange includes a first trackconfigured to connect to the inner tube, and wherein the proximalportion is located near the first track and is profiled to limit stressin the first flange produced by interaction between the first track andthe inner tube.
 13. The forceps of claim 12, wherein the profile of theproximal portion is configured to maintain a minimum thickness betweenthe first track and the proximal portion.
 14. The forceps of claim 13,wherein the minimum thickness is 0.7 millimeters.
 15. The forceps ofclaim 12, wherein the profile of the proximal portion of the firstflange includes an edge having an arc tangent to a top edge.
 16. Theforceps of claim 15, wherein the arc of the edge is eccentric with anarc of the first track.
 17. The forceps of claim 16, wherein the arc ofthe edge has a radius of curvature that is larger toward a laterallyinner portion than a laterally outer portion when the flange is in theopen position.
 18. The forceps of claim 11, wherein the first flange hasa shape that is symmetric about one or more axes.
 19. A forcepscomprising: an outer tube extending along a longitudinal axis, the outertube including a pair of outer arms extending from a distal portion ofthe outer tube; a first jaw pivotably connected to the outer tube, thefirst jaw including a first flange and a second flange each located at aproximal portion of the first jaw, the first flange and the secondflange each including a proximal portion extending outward of the outertube when the jaws are in an open position, the proximal portionsradiused to limit extension of the proximal portions laterally beyondthe arms when the first jaw is in an open position; a second jawconnected to the outer tube; and an inner tube located within the outertube and extending along the longitudinal axis, the inner tube connectedto the first flange and the second flange, the inner tube translatablealong the outer tube to drive the first flange and the second flange tomove the first jaw and the second jaw between the open position and aclosed position.
 20. The forceps of claim 19, wherein the first flangeincludes a first track configured to connect to the inner tube, andwherein the proximal portion is located near the first track and isprofiled to limit stress in the first flange produced by interactionbetween the first track and the inner tube.
 21. The forceps of claim 20,wherein the profile of the proximal portion is radiused to maintain aminimum thickness between the first track and the proximal portion.